不同年龄段多囊卵巢综合征患者卵巢功能评估

Evaluation of the ovarian function of patients with polycystic ovary syndrome at different ages

目的：评估不同年龄阶段的多囊卵巢综合征（polycystic ovarian syndrome,PCOS）患者的卵巢功能。方法：189例PCOS患者纳入本次研究,详细了解患者病史、进行常规体格检查、阴式超声检测,克罗米芬刺激试验（clomiphene citrate challenge tes,CCCT）,性激素测定,并对患者进行促排卵治疗,观察不同年龄组患者的妊娠率。结果：20~34岁组和35~39岁组的PCOS患者的平均窦卵泡数目、基础FSH水平、CCCT异常数和妊娠率相比差异没有统计学意义。而40~46岁组的PCOS患者平均窦卵泡数目减少,基础FSH水平升高,与其他年龄组比较差异有明显的统计学意义（P〈0.05）;CCCT异常例数明显增高,促排卵后妊娠率明显下降,差异有明显的统计学意义（P〈0.05）。结论：PCOS患者的生育窗可能延长到40岁,40岁以后的PCOS患者卵巢储备功能明显下降,促排卵治疗效果欠佳,妊娠率低。通过不同年龄不同卵巢储备的PCOS患者的研究,对PCOS的不孕患者的临床妊娠有指导意义。

Objectives： To evaluate the ovarian function of patients with polycystic ovary syndrome（ PCOS）at different ages. Methods： 189 patients with PCOS were included in this study. The medical history was taken;physical examination,ultrasonic testing and Chlorine stimulation test was performed; sex hormones level was determined and ovulation was stimulated. The pregnancy rate in patients at different ages was compared. Results： Difference in basic FSH levels,the number of sinus follicle,CCCTS abnormal number and pregnancy rate between patients of 20 ~ 34 and 35 ~ 39 age groups was not statistically significant. The average numbers of sinus follicle decreased and basic FSH levels increased more significant in PCOS patients of 40 ~ 46 age group than the other groups（ p〈 0. 05）. But CCCT abnormal cases increased obviously,and the pregnancy rates after ovulation stimulation decreased compared with other age groups,with statistically significant difference（ p〈 0. 05）. Conclusion： The fertility window of PCOS patients may extend to 40 years old,and the ovarian reserve function declines obviously after40. Stimulating ovulation treatment is of poor effect and low pregnancy rate. Study on the ovarian reserve function of PCOS patients at different ages is of guiding significance to the clinical pregnancy.