克罗米芬联合促卵泡素治疗PCOS合并不孕的疗效分析

Analysis of the effects of clomiphene citrate and follicle stimulating hormone for PCOS complicated with infertility

目的:探讨克罗米芬联合促卵泡素治疗多囊卵巢综合征(PCOS)合并不孕的临床疗效。方法:对51例PCOS合并不孕患者进行克罗米芬促排卵联合促卵泡素治疗,当优势卵泡直径>18 mm时予以人绒毛膜促性腺激素(HCG)肌肉注射,排卵后采用黄体孕酮胶丸支持治疗,记录月经周期第8天优势卵泡直径、应用HCG日子宫内膜厚度、最大卵泡直径、直径>15 mm的卵泡数、排卵率、妊娠率。结果:51例患者月经周期第8天卵泡直径为(0.81±0.11)cm,优势卵泡直径>18 mm时子宫内膜厚度为(0.93±0.14)cm,最大卵泡直径为(1.97±0.14)cm,直径≥1.5 cm个数为(1.56±0.97)个,51例患者平均排卵个数为(1.39±0.69)个,其中47例排卵,排卵率为92.2%,10例妊娠,妊娠率为19.6%。所有患者均完成治疗,其中2例患者发生轻度卵巢过度刺激综合征,1例患者注射HCG后出现黄素化综合征。结论:在PCOS合并不孕患者克罗米芬促排卵治疗中,于月经周期第8天应用尿促卵泡素,有利于获得如自然周期的单卵泡发育排卵。

Objective： To investigate the effects of clomiphene citrate and follicle stimulating hormone for polycysticovary syndrome（ PCOS） complicated with infertility. Methods： 51 patients with PCOS complicated with infertility were treated with clomiphene citrate for ovulation,the dominant follicle diameter 18 mm,intramuscular injection of human chorionic gonadotropin（ HCG） was used,and luteal progesterone capsules were used after ovulation,recording dominant follicle diameter,endometrial thickness of HCG,diameter of the largest follicle,the number of the diameter 〉15 mm follicle,the ovulation rate and pregnancy rate at 8 d. Results： Follicular diameter of 51 patients was（ 0. 81 ± 0. 11） cm at 8 d of the menstrual cycle,the dominant follicle diameter 18 mm,the endometrial thickness was（ 0. 93 ± 0. 14） cm,the diameter of the largest follicle was（ 1. 97 ± 0. 14） cm,the number of follicular diameter≥1. 5 cm was（ 1. 56 ＋ 0. 97）. The average ovulation number of 51 patients was（ 1. 39 ＋0. 69）,including 47 cases of ovulation,the ovulation rate was 92. 2%,10 cases of pregnancy,the pregnancy rate was 19. 6%. All patients completed the treatment,2 patients of which occurred mild ovarian hyperstimulation syndrome,1 patients appeared follicle syndrome after HCG injection. Conclusion： Clomiphene is used in infertility patients with PCOS,urinary follicle stimulating hormone is used on cycle day 8,it is beneficial to obtainning the single follicular ovulation as those in natural cycle.