多囊卵巢综合征不孕患者未成熟卵泡抽吸术的疗效分析

Clinical Efficacy of Treating Infertile Women with Polycystic Ovary Syndrome by Using Ultrasound-guided Immature Follicle Aspiration

目的:探讨对克罗米芬抵抗的多囊卵巢综合征(PCOS)不孕患者在超声引导下行小卵泡抽吸术(IMFA)的治疗效果。方法:将42例PCOS合并克罗米芬(CC)抵抗的不孕患者,随机分为A组:19例,穿刺前用CC或来曲唑(LE)联合少量hMG促排卵;B组:23例,穿刺前用少量hMG促排卵。在阴道B超引导下进行未成熟卵泡抽吸术(IMFA),观察穿刺前及穿刺后第2周期患者的卵巢基础窦卵泡数(AFC)、抗苗勒氏管激素(AMH)、血中游离睾酮指数(FAI)、黄体生成素与卵泡刺激素的比值(LH/FSH),以及术后并发症、3个月促排卵情况和妊娠率。结果:42例患者治疗时均没有发生卵巢过度刺激综合征(OHSS)。与治疗前比较,穿刺术后A、B组AFC显著减少,AMH、FAI和LH/FSH显著降低(P<0.01)。A、B组间比较,FAI、LH/FSH、排卵率和妊娠率无统计学差异(P>0.05)。A、B组共21例妊娠,妊娠率为50%。42例患者均没有发生出血、感染、OHSS。结论:IMFA治疗克罗米芬抵抗的PCOS不孕患者有较好的疗效,本方法安全、有效。

Objective： To investigate the clinical efficacy of treating infertile women with polycystic ovary syndrome （PCOS） by using ultrasound-guided immature follicle aspiration （IMFA）. Methods： A total of 42 infertile women with PCOS and clomiphene （CC） resistance were randomly divided into two groups. Group A： 19 cases were induced ovulation with CC or letrozole （LE） combined with small amount of hMG before puncture. Group B： 23 cases were induced ovulation with a small amount of hMG before puncture. After IMFA, endocrine function, ovulation instance and pregnancy rate within 3 months were observed. Results： Ovary hyperstimulation syndrome did not occur in all cases. Compared with pre-treating, free androgen index （FAI） in blood, anti-Mtillerian hormone （AMH）, ratio of luteinizing hormone （LH） and follicle stimulating hormone （FSH） were significantly lower （P〈0.01）, and rates of ovulation and pregnancy were significantly improved after IMFA （P〈0.01）. Conclusion： IMFA would have a good clinical efficacy for treating infertile women with PCOS, and would be safe.