腹腔镜与垂体降调节治疗难治性多囊卵巢综合征的比较

The Response of Infertile Patients with Refractory Polycystic Ovarian Syndrome to Ovulation Induction Posterior to Laparoscopic Ovarian Drilling or Pituitary Down Regulation.

目的 研究腹腔镜卵巢多点打孔与GnRH -a垂体降调节治疗难治性多囊卵巢综合症 (PCOS)合并不孕症患者在治疗后激素水平、排卵率、妊娠率、流产率方面的差异 .方法 选择 42例难治性PCOS患者 ,并随机分为 2组 :(1)腹腔镜手术组 2 1例 :经腹腔镜多点打孔后 ,促排卵治疗 ;(2 )垂体降调节治疗组 2 1例 :经GnRH -a垂体降调节后 ,促排卵治疗 .两组促排卵治疗方案均为 :FSH +HMG +HCG .结果 两组在激素水平变化方面有不同的表现 ,而在排卵率、妊娠率、流产率方面无明显差异 .结论 用GnRH

Objective To assess the endocrine change (sex hormone level) and clinic outcome (ovulation rate,pregnancy rate,abortion rate), and in an attempt to determine the mechanism of action in infertile patients with refractory polycystic ovarian syndrome(PCOS) using laparoscopic ovarian drilling or pituitary down regulation prior to ovulation induction.Methods 42 patients were equally divided into two groups randomly. The serum levels of LH, FSH, T, E 2 were determined before and after laparoscopic ovarian drilling and GnRH-a pituitary down regulation. Two groups were used the same ovulation induction regimen ( FSH+HMG+HCG ) after laparoscopic ovarian drilling and GnRH-a pituitary down regulation. Results No statistic difference was found in clinic outcome,but the sex hormonal change was different. Conclusions GnRH-a pituitary down regulation can substitute for laparoscopic ovarian drilling in treating patients with refractory PCOS.