排卵障碍患者促排卵成功妊娠36例分析

Clinical analysis on 36 patients of anovulation achieving successful pregnancy by ovulation induction

目的探讨和比较促排卵受孕周期和未孕周期的卵泡发育、子宫内膜生长变化、尿LH峰出现、卵泡与子宫内膜同步性的差异。方法收集36例排卵障碍患者促排卵后成功受孕周期（36周期）及前期未孕周期（72周期）的卵泡监测情况。结果受孕周期平均排卵日（14.39±2.28）d、排卵时卵泡大小（19.75±1.93）mm、卵泡数（1.58±0.77）个、LH峰出现20次;未孕周期平均排卵日（14.44±2.48）d、排卵前卵泡大小（18.93±1.28）mm、卵泡数（1.42±0.65）个、LH峰出现24次,二者在排卵前卵泡大小和LH峰出现频率上差异有统计学意义（P〈0.05）,其他方面差异无统计学意义（P〉0.05）。排卵前子宫内膜厚度受孕周期的两个高峰区间分别是0.7~0.8cm（10例）、1.1~1.2cm（15例）,而未孕周期分布于0.7~0.8cm（24例）、0.9~1.0cm（26例）。子宫内膜厚度与卵泡大小的相关性方面受孕周期r=0.341,未孕周期r=0.318,两组之间差异无统计学意义。结论两组在卵泡大小和LH峰出现频率上的差异体现了促排卵成功受孕的关键在于卵泡的质量,同时最宜受孕的内膜厚度是1.1~1.2cm。

Objective To investigate and compare the differences between pregnancy cycles by ovulation induction and non-pregnancy cycles, including follicular development, the growth of endometrial changes, urinary LH peak, follicular and endometrial synchronization. Methods The clinical data of 36 patients of anovulation achieving successful pregnancy after ovulation induction were collected. The follicular monitoring was compared between the pregnancy cycles （36 cycles） and the non-pregnancy cycles （72 cycles）. Results In the pregnancy cycles, the average day of ovulation, the size of preovulatory follicles, the number of follicles, and the frequency of urinary LH peak were （14.39±2.28） days, （19.75±1.93） mm, （1.58±0.77）, and 20 times, respectively. In the non-pregnancy cycles, the above mentioned indexes were （14.44±2.48） days, （18.93±1.28） mm, （1.42±0.65）, and 24 times, respectively. Statistically significant difference was found in the size of preovulatory follicles and LH peak frequency between the pregnancy cycles and the non-pregnancy cycles （P0.05）. The peaks in the endometrial thickness before ovulation in pregnancy cycles were 0.7~0.8 cm （10 cases） and 1.1~1.2 cm （15 cases）, while that in the non-pregnancy cycles were 0.7~0.8 cm （24 cases） and 0.9~1.0 cm （26 cases）. The correlation between the follicle size and endometrial thickness in pregnancy cycles （r=0.341） showed no significant difference with that in the non-pregnancy cycles （r=0.318）. Conclusion The key to a successful pregnancy is the quality of the follicle, and the most appropriate endometrial thickness is 1.1~1.2 cm.