PCOS患者药物促排卵中LUFS发生的相关因素

Analysis at the factors related with hrteinized unrupture faffide syndrane of patients with potycystic ovarian syndrome after ovulation induction

目的 探讨多囊卵巢综合征(PCOS)患者药物诱导排卵治疗中发生未破裂黄素化卵泡综合征(LUFS)的相关因素。方法 对比克罗米酚(CC)及人绝经后促性腺激素(HMG)方案用药前后PCOS患者血清PRL、FSH、LH、E_2、T水平,阴道超声检查卵巢形态,分析PCOS患者LUFS发生与基础性激素水平和卵巢形态的关系。结果 应用CC加用HCG45例,卵泡发育率66.67％,周期妊娠率为22.22％,LUFS发生率33.33％;应用CC无效者,应用HMG方案30例,卵泡发育率高(86.67％),但LUFS和过度刺激综合征(OHSS)发生率高分别为36.67％和13.33％,周期妊娠率16.67％。T水平LUFS组高于排卵组,表明LUFS的发生与血清睾酮水平有关。周边囊泡型多囊卵巢(PCP)LUFS发生率25％,普通囊泡型多囊卵巢(GCP)LUPS发生率75％。结论 普通囊泡型多囊卵巢患者易于发生卵泡黄素化不破裂综合征,可能与患者雄激素水平相对较高,卵巢包膜厚,优势卵泡不是发生在卵巢周边有关。

Objective To study the relationships of luteinized unnipture follicle syndrome (LUFS) and serum basal FSH,LH,PRL,E2 ,Testerone (T) and the patterns of ovaries in patients with PCOS after ovuladon induction. Methods Compared the basal FSH,LH,Testerone and the patterns of ovaries in patients with PCOS before and after treatment. Results 66.67% of infertile patients with PCOS treated with chlomiphen (CC) plus HCG45 cycles,developed dominant follicles,and the pregnancy rate was 22.22% ,while LUFS rate was 33.33%. Those treated with human menopausal gonadotropins (HMG) 30 cycles,86.67% developed dominant follicles,pregnancy rate was 16.67% ,but LUFS rate was 36.67% . The level of testerone in LUFS group was highter than ovulation group. The rates of LUFS were 25% in peripheral cystic pattern (PCP) and 75% in general cystic pattern (GCP). Condusians PCOS with GCP is easier to develope LUFS. Probably it is related with high tester-one,the thick capsule of ovary and the site of dominant follicle.