原因不明月经过少妇女的临床特征和受孕结局

Clinical characteristics and conception outcome of the women with unexplained hypomenorrhea

目的:寻找原因不明月经过少妇女的实验室和临床特征。方法:110名原因不明月经过少有生育意愿的妇女为研究组及330名月经正常有生育意愿的妇女为对照组,B超观察妇女子宫内膜容受性的临床特征,如内膜厚度、内膜类型、肌层回声、子宫动脉搏动指数以及内膜血流,同时测定黄体中期血雌二醇(E2)、孕酮(P)水平,血凝水平和抗体指标,并对妇女1年内的受孕情况进行随访。结果:研究组妇女的子宫内膜容受性评分低于对照组(9.41±3.02 vs 15.67±2.63,P<0.01),黄体中期E2水平较低(172.35±27.54 ng/L vs 220.27±30.28 ng/L,P<0.01)。研究组1年内自然受孕率低于对照组(60.0%vs 72.1%,P<0.05),孕早期自然流产率(33.3%vs 12.9%,P<0.01)较高。结论:原因不明月经过少妇女表现为子宫内膜容受性差,1年内自然受孕率低,建议在孕前给予黄体功能和子宫内膜容受性的检测。

Objective： To investigate the clinical characteristics, conception and early pregnancy outcome of the women with unexplained hypomenorrhea. Methods： Totally 110 women with unexplained hypomenorrhea as study group and 330 women as control group were involved. Their endometrial receptivity, such as endometrial thickness, endometrial layer, echo of the uterine muscle, pulse index（PI） of uterine artery, blood in endometrium were observed by ultrasound, and levels of estradiol, progesterone, blood coagulation and antibody in midluteal phase were tested and their conception and early pregnancy outcome within 1 year were followed up. Results： The endometrial receptivity score of the women with unexplained hypomenorrhea was significantly lower than that of normal women（9.41 ± 3.02 vs 15.67 ± 2.63, P〈0.01）, as well as the level of E2（172.35 ± 27.54 ng/L vs 220.27 ±30.28 ng/L, P〈0.01） in midluteal phase. The nature conception rate within 1 year in study group was notably lower（60.0% vs 72.1%, P〈0.05）, but spontaneous abortion rate in early pregnancy in study group was notably higher than that in control group（33.3% vs 12.9%, P〈0.01）. Conclusion： Unexplained hypomenorhea women have bad endometrial receptivity, and low nantural conception with 1 year. It is suggested to administer the examination on corpus function and endometrial receptivity.