HMG单药及联合氯米芬对排卵障碍患者卵泡生长的干预研究

A Clinical Study of Single Human Menopausal Gonadotropin or Combined with Clomiphene Citrate to Interfere Folliculogenesis in Patients with Ovulation Failure

目的探讨不同方案人绝经期促性腺激素（human menopausal gonadotropin,HMG）对排卵障碍患者促排卵治疗后的卵泡生长规律。方法将符合入选标准的排卵障碍20例随机分为HMG组和氯米芬（clomiphene citrate,CC）加HMG组,每组各10例,另选择10例正常排卵妇女为对照组。HMG组自经期第5天始,予肌内注射HMG 75 U/d至卵泡成熟;CC＋HMG组于经期第5天始口服CC50 mg/d,第9天予肌内注射HMG75 U/d至卵泡成熟。3组分别于月经周期的第3~5、10~11、12~13、14~15天及卵泡成熟期行经阴道彩超检查,监测卵泡大小、数目等情况。结果两治疗组大多可以在经期第10~11天获得优势卵泡,优势卵泡随后以1.5 mm/d速度向成熟卵泡发育,3组卵泡大小及优势卵泡增长速度比较均无统计学差异（P〉0.05）。结论单用HMG或CC加HMG方案均可以改善排卵障碍,获得与正常卵泡相似的卵泡发育。

Objective To investigate the folliculogenesis regulation in patients with ovulation failure after they received different protocols of Human Menopausal Gonadotropin（HMG） for ovarian stimulation.Methods 20 patients with ovulation failure and coincident selection standards were randomly divided into HMG group and（Clomiphene citrate,CC）combined with HMG group（10 in each）,and 10 women with normal vulation were enrolled in control group.HMG group received HMG（75 U/d） from the 5th day in menstrual period until ovarian follicle maturated,and CC combined with HMG group received CC（50 mg/d） from the 5 th day and HMG（75 U/d） from the 9th day in menstrual period until ovarian follicle matured.The size and number of ovarian follicle were monitored with the help of transvaginal ultrasound on day 3~5,day 10~11,day 12~13 in menstrual cycle.Results Most patients in the two treatment groups could have dominant ovarian follicles on day 10~11,and the dominant ovarian follicles grew to maturation at a speed of 1.5 mm/d.There was no significant difference in the number of ovarian follicles and growth speed of dominant ovarian follicles between the 3 groups（P0.05）.Conclusion The ovarian stimulation protocols with HMG,or CC combined with HMG can improve the situation of ovulation disorder,and can be induced to similar follicular development as normal ovarian follicle.