不同治疗方案对排卵障碍性不孕患者成熟卵泡数量及妊娠率的影响

Effect of different therapeutic regimens on the number of mature follicles and pregnancy rate in patients with ovulatory infertility

目的观察不同治疗方案对排卵障碍性不孕患者成熟卵泡数量及妊娠率的影响。方法选取排卵障碍性不孕患者86例,随机分为A组和B组,每组43例。A组采用注射用尿促性素+来曲唑治疗,B组采用注射用尿促性素+克罗米芬治疗,治疗6个月经周期。比较2组促排卵效果[人绒毛膜促性腺激素(HCG)日子宫内膜厚度、成熟卵泡数量、排卵率、妊娠率]、治疗前后血清性激素[卵泡刺激素(FSH)、雌二醇(E2)、促黄体生成素(LH)]变化和不良事件发生率。结果治疗后A组HCG日子宫内膜厚度大于B组,排卵率、妊娠率和血清E2、FSH、LH水平均高于B组,成熟卵泡数、卵巢过度刺激综合征(OHSS)和多胎妊娠发生率低于B组,差异均有统计学意义(P<0.05或0.01)。结论相比注射用尿促性素+克罗米芬方案,注射用尿促性素+来曲唑治疗排卵障碍性不孕患者,有助于提升其促排卵效果,提高妊娠率,改善血清性激素水平,减少不良事件的发生。

Objective To observe the effect of different therapeutic regimens on the number of mature follicles and pregnancy rate in patients with ovulatory infertility. Methods A total of 86 patients with ovulatory infertility treated in a hospital were selected and randomly divided into Group A(n=43) and Group B(n=43). Group A was injected with menotrophin + letrozole while Group B was injected with menotrophin + clomiphene, and both groups received the treatment for six menstrual cycles. The two groups were compared in terms of ovulation promotion effect(endometrial thickness of human chorionic gonadotropin(HCG), the number of mature follicles, ovulation rate and pregnancy rate), changes of serum sex hormones [follicle stimulating hormone(FSH), estradiol(E2), and luteinizing hormone(LH)] before and after the treatment, and the incidence of adverse events. Results After the treatment, Group A had the HCG endometrial thickness greater than Group B, had the ovulation rate and pregnancy rate as well as serum E2, FSH and LH level higher than Group B and had the number of mature follicles and the incidence of ovarian hyperstimulation syndrome(OHSS) and multiple pregnancy lower than Group B(P<0.05), and the differences were statistically significant(P<0.05 or 0.01). Conclusion Compared with the regimen of injection with menotrophin + clomiphene, injection with menotrophin + letrozole can help improve ovulation promotion, increase pregnancy rate, improve serum sex hormone levels and reduce the incidence of adverse events in the treatment of patients with ovulatory infertility.