溴隐亭联合促排卵药治疗高催乳素血症伴多囊卵巢综合征不孕患者的疗效分析

目的:探讨溴隐亭配合促排卵治疗高催乳素血症伴多囊卵巢综合症(PCOS)不孕患者的治疗方案与效果。方法:回顾性分析2006年6月～2009年2月在我院确诊为高催乳素血症伴PCOS不孕患者31例,根据溴隐亭使用方案不同分为两组。Ⅰ组18例,溴隐亭从1.25～2.5mg/d开始,逐渐加量至5～7.5mg/d,使催乳素水平维持正常后逐渐减少溴隐亭用量(每日减少1.25mg),至溴隐亭维持至1.25～2.5mg,至少3周,然后于月经第5天加用克罗米芬促排卵治疗,于月经第9天B超检查若无优势卵泡生长则加用尿促性素(HMG)75u/d,至卵泡直径达20mm时,改用人绒毛膜促性腺激素(HCG)5000～10000Iu,HCG用药后第2天及第3天各指导同房。Ⅱ组13例,溴隐亭初始治疗剂量同Ⅰ组,并在开始溴隐亭治疗的同时进行促排卵治疗。用法也同Ⅰ组。结果:Ⅰ组与Ⅱ组相比,Ⅰ组HMG用量少,妊娠率高。结论:高催乳素血症伴PCOS不孕患者,先用溴隐亭正规治疗至催乳素正常3周后联合促排卵治疗,能减少促排卵药的使用时间及剂量,提高妊娠率。

Objective:To investigate the ovulation induction with bromocriptine in hyperprolactinemia with polycystic ovary syndrome (PCOS) in patients with infertility and the effect of the treatment program.Methods:A retrospective analysis from June 2006 to February 2009 at our hospital diagnosed with PCOS hyperprolactinemia in patients with 31 cases of infertility,according to bromocriptine were divided into two groups using different programs.18 cases of group Ⅰ,bromocriptine from 1.25mg-2.5mg /d beginning and gradually increase the volume to 5～7.5mg/d,so that the maintenance of normal prolactin levels gradually reduce the amount of bromocriptine (daily to reduce the 1.25 mg),to bromocriptine to maintain 1.25～2.5 mg,at least three weeks,and then the first five days in the menstrual add ovulation induction with clomiphene citrate on the 9th day period B ultrasonography while the absence of dominant follicle growth and add with Su-hMG (HMG)75u / d,to the follicle 20mm diameter,the switch to human chorionic gonadotropin (HCG) 5000-10000Iu,HCG administration and two days after the first three days of the guidance of the same room.13 cases of group Ⅱ,the initial dose bromocriptine with groupⅠ,and at the start of bromocriptine treatment for ovulation induction at the same time. Use the same groupⅠ.Results:Group Ⅰand groupⅡ,Ⅰgroup with less than HMG, high pregnancy rate.Conclusion:Hyperprolactinemia associated with infertility in patients with PCOS,the first formal use of bromocriptine treatment of prolactin to normal 3 weeks after the United ovulation induction,ovarian hyperstimulation can reduce the time and the use of drug dosage to improve the pregnancy rate.