多囊卵巢综合征促排卵失败的相关因素探讨

Risk Factors of Superovulation Failure in PCOS Patients

探讨多囊卵巢综合征（ＰＣＯＳ）妇女促排卵失败的危险因素。方法：将 １０３名ＰＣＯＳ病人，随机分为 ３组，分别以 ＣＣ／ ｈＣＧ、ＣＣ／ｈＭＧ／ｈＣＧ及 ＧｎＲＨ－ａ／ｈＭＧ／ｈＣＧ三种促排卵方案治疗，并以 ３１名正常妇女作对照，应用放免法测定４组对象血清性激素水平。应用糖耐量试验及胰岛素释放试验测定糖负荷后 ０ ｍｉｎ、 ６０ ｍｉｎ、 １２０ ｍｉｎ血糖及胰岛素水平。结果：促排卵治疗失败者卵巢过度刺激综合征（ＯＧＴＴ）后 １２０ ｍｉｎ胰岛素水平明显增高，与排卵者相比，Ｐ＜０．０５，ＯＲ＝１．０１３；而 ＣＣ／ｈＭＧ／ｈＣＧ治疗方案失败率较低，ＯＲ＝０． ３１１０。结论：ＯＧＴＴ后 １２０ ｍｉｎ胰岛素是促排卵失败的危险因素， ＣＣ／ｈＭＧ／ｈＣＧ方案是较为成功的促排卵治疗方案。

Objective: To explore the risk factors of superovulation failure in PCOS patients. Methods: Sex hormones were measured in 103 PCOS patients and 31 healthy women using radioimmunologic assay. They all underwent glucose tolerance test (OGTT) and insulin release test. Three superovulation methods were used to treat the patients with PCOS induced infertility: CC/ hCG, CC/hMG/hCG and GnRH-a/hMG/hCG. Results: The blood insulin level in non-ovulation women is higher than that in those with ovulation 2 h after OGTT, P<0. 05, OR= 1. 013; The CC/hMG/hCG group had a lower non-ovulation rate, OR~=0. 3110. Conclusion: High blood insulin level is a risk factor of superovulation outcome while CC/hMG/hCG method an effective way of superovulation remedy.