二甲双胍联合炔雌醇环丙孕酮治疗后促排卵方案对多囊卵巢综合征不孕患者的疗效观察

Effect of metformin combined with ethinylestradiol cyprogesterone on ovulation induction in infertility patients with polycystic ovary syndrome

目的探讨二甲双胍联合炔雌醇环丙孕酮治疗后促排卵方案对于多囊卵巢综合征(PCOS)不孕症患者的临床效果。方法确诊为PCOS不孕症的86例患者随机分为实验组与对照组,各43例。实验组患者应用二甲双胍联合炔雌醇环丙孕酮的方式进行治疗,对照组则仅应用炔雌醇环丙孕酮进行治疗。所有患者治疗结束后均予以相同的促排卵处理与黄体支持以及性生活指导方案。对两组患者治疗前后的激素水平以及治疗后的排卵与妊娠和流产等情况进行记录与对比分析。结果经过治疗后,两组患者的激素水平均得到了一定程度的改善,实验组患者经过治疗后,其卵泡刺激素(FSH)得到一定的提高,且黄体生成素(LH)、胰岛素和睾酮(T)均降低,差异均有统计学意义(均P<0.05)。此外,实验组流产患者2例,对照组4例,差异相对较小(P>0.05)。而在排卵及妊娠方面,实验组分别为83.7%与46.5%,而对照组分别为62.8%与23.3%,差异有统计学意义(P<0.05)。结论二甲双胍对于葡萄糖的摄取存在一定程度的抑制效果,因此有利于提高机体对于胰岛素的敏感性,因而对于患者机体内胰岛素分泌水平以及胰岛素抵抗等方面具有较好的改善效果,从而促进患者代谢水平逐渐恢复正常。二甲双胍联合炔雌醇环丙孕酮治疗后促排卵方案可改善PCOS不孕患者的妊娠结局。

Objective To investigate the clinical effect of ethinylestradiol cyprogesterone combined with metformin in treatment of infertility complicated with polycystic ovary syndrome(PCOS).Methods Eighty-six infertility patients with PCOS admitted were randomly divided into study group and control group.Patients in the sduty group were treated with ethinylestradiol cyprogesterone combined with metformin,while patients in the control group were treated with e thinylestradiol cyprogesterone alone.All patients received the same ovulation induction,luteal support and sexual orientation regimen.The hormone levels before and after treatment,ovulation,pregnancy and abortion of the two groups were observed and compared.Results After treatment,the hormone levels in both groups were improved to a certain extent.The FSH level was improved,and LH,insulin and T levels were decreased in the study group(P<0.05).There were 2 cases of abortion in the study group and 4 cases in the control group(P>0.05).The ovulation rate and pregnancy rate in study group were significantly higher than those in control group(83.7%vs 62.8%and 46.5%vs 23.3%,both P<0.05).Conclusion Ethinylestradiol and ciprogesterone combined with metformin can improve pregnancy outcome in infertility patients with polycystic ovary syndrome.