多囊卵巢综合征不孕症患者着床窗期子宫内膜容受性情况及促排卵治疗对其的影响

The Situation of Implantation Window Endometrial Receptivity in Infertility Patients with PCOS and Effect of Ovulation Induction Treatment

目的:探讨观察多囊卵巢综合征(PCOS)与非PCOS不孕症患者着床窗期子宫内膜容受性差异以及促排卵治疗对其的影响。方法:选取PCOS不孕患者56例,将其随机分为A、B两组,每组28例,A组采用氯米芬(CC)人绒毛膜促性腺激素(HCG)促排卵治疗,B组采用归肾丸+CC/HCG促排卵治疗,同时选取同期因男性不育或输卵管因素就诊的不孕症患者28例作为对照组(C组)。比较各组患者着床窗期子宫内膜容受性情况。结果:与C组比较,A组的子宫内膜厚度明显减少、子宫内膜下螺旋动脉血流搏动指数(PI)水平显著升高,差异有统计学意义(P<0.05),而血清雌二醇(E2)、孕酮(P)及白血病抑制因子(LIF)表达水平无明显差异,差异无统计学意义(P>0.05);B组的子宫内膜厚度、PI及血清E2水平无明显差异,差异无统计学意义(P>0.05),血清P水平和子宫内膜LIF表达水平明显优于C组,差异有统计学意义(P<0.05)。结论:与非PCOS不孕症患者相比,CC促排卵治疗的PCOS不孕症患者着床窗期子宫内膜容受性有所降低,归肾丸+CC促排卵治疗的PCOS不孕症患者的子宫内膜容受性则明显改善。

Objective To investigate and observe the difference of implantation window endometrial receptivity between P- COS and non - PCOS infertility and the effects of ovulation induction. Method 56 patients with PCOS were selected. They were randomly divided into two groups （28 casese in each group）. Group A was given CC/HCG treatment while group B was given guishen pill ＋ CC/HCG treatment. Totally 28 women having problems of tubal who underwent artificial insemination were recruited as group C. Compare implantation window endometrial receptivity among each group. Results Compared with C group, the endometrial thickness in A group decreased significantly, endometrial spiral artery blood flow index （PI） were significantly increased （P 〈 0. 05 ）, but there was no significant difference in the expression level of serum E2, P and LIF （ P 〉 0. 05 ） ; B group, there was no significant in endometrial thickness and serum level of E2 and PI （ P 〉 0. 05 ）, serum P level and endometrial LIF level was higher than that of group C （ P 〈 0. 05 ）. Conclusion Compared with non PCOS patients with infertility, endometrial receptivity of infertility patients with PCOS implantation window CC ovulation treatment decreases, Guishen Pill improves the endometrial receptivity.