子宫内膜微创预处理对多囊卵巢综合征不孕患者促排卵后子宫内膜形态和受孕率的影响

Effect of minimally invasive endometrial pretreatment on endometrial morphology and pregnancy rate of patients with polycystic ovary syndrome after ovulation treatment

目的探讨多囊卵巢综合征（PCOS）患者促排卵治疗中子宫内膜微创预处理对子宫内膜形态、厚度及临床妊娠率的影响。方法选择2014年1~12月在本院就诊的PCOS育龄期不孕症患者66例,随机将所有患者分为观察组和对照组各33例,所有患者应用优思明治疗3~6个月后,用克罗米芬（CC）促排卵治疗,观察组在对照组治疗基础上,在早卵泡期（月经第3~5天）应用一次性宫腔组织吸引管对子宫内膜行搔刮轻创术。比较两组患者排卵日子宫内膜形态、厚度及临床妊娠率。结果微创预处理前两组患者的年龄、不孕年限、基础卵泡刺激素（FSH）及基础黄体生成激素（LH）比较差异均无统计学意义（P〉0.05）;观察组患者刺激后子宫内膜厚度与对照组比较差异无统计学意义（P〉0.05）,但子宫内膜形态较刺激前有明显改善,同时与对照组比较差异有显著统计学意义（P〈0.01）;观察组的临床妊娠率为36.36%（12/33）,明显高于对照组的12.12%（4/33）,差异有统计学意义（P〈0.05）。结论早卵泡期采用一次性宫腔组织吸引管进行微创机械刺激子宫内膜是一种安全有效的方法,能够有效改善PCOS不育患者的子宫内膜容受性,提高患者妊娠率。

Objective To study the effect of minimally invasive endometrial pretreatment on the endome- trial morphology, thickness and the clinical pregnancy rate of patients with polyeystic ovary syndrome （PCOS） af- ter ovulation treatment. Methods Sixty-six patients with PCOS were selected from January to December in 2014. All the patients were randomly divided into the observation group and the control group, with 33 patients in each group. All the patients were treated with Yasmin for 3 to 6 months, and clomiphene citrate （CC） for ovulation induc- tion treatment. The observation group additionally applied minimally invasive endometrial pretreatment with dis- posable uterine cavity tissue suction tube in the early follicular phase （in the third to fifth day of menstruation）. The endometrial morphology at ovulation, thickness and the clinical pregnancy rate were compared between the two groups. Results The age, duration of infertility, basal follicle stimulating hormone （FSH） and basal luteinizing hormone （LH） of two groups before the minimally invasive pretreatment showed no statistically significant differ- ence between the two groups （P〉0.05）. The endometrial thickness after stimulation also bad no statistically signifi- cant difference between the two groups （P〉0.05）, but the endometrial morphology after stimulation was significant- ly improved compared with that before stimulation, with statistically significant difference between the two groups （P〈0.01）. The clinical pregnancy rateof observation group was 36.36% （12/33）, significantly higher than 12.12% （4/33） in the control group （P〈0.05）. Conclusion It is a safe and effective method to apply minimally invasive mechanical stimulation of endometrium with disposable uterine cavity tissue suction tube in the early follicular phase, which can effectively improve the endometrial receptivity of infertile patients with PCOS and improve the pregnancy rate.