二甲双胍联合炔雌醇环丙孕酮治疗对多囊卵巢综合征不孕症患者雌孕激素、排卵率、妊娠率的影响

Effects of metformin combined with ethinylestradiol cyproterone on estrogen,progesterone,ovulation rate and pregnancy rate in patients with PCOS infertility

目的观察二甲双胍联合炔雌醇环丙孕酮治疗对多囊卵巢综合征(PCOS)不孕症患者雌孕激素、排卵率及妊娠率的影响。方法收集2017年1月至2018年11月该院收治的PCOS不孕症患者114例为研究对象,依随机数字表达的随机分组原则将其分为观察组(n=57,予以二甲双胍联合炔雌醇环丙孕酮治疗)和对照组(n=57,予以炔雌醇环丙孕酮治疗),治疗3个周期后,比较其雌孕激素、卵泡发育情况、排卵率、妊娠率及安全性。结果治疗3个周期后,两组雌二醇(E2)、促卵泡刺激素(FSH)水平均较治疗前升高,促黄体生成素(LH)较治疗前降低,差异均有统计学意义(P<0.05),且观察组治疗3个周期后的E2、FSH水平高于对照组(P<0.05),LH水平低于对照组(P<0.05);治疗3个周期后,观察组成熟卵泡数目高于对照组,差异有统计学意义(P<0.05),两组成熟卵泡直径和子宫内膜厚度比较,差异无统计学意义(P>0.05);治疗3个周期后,观察组87.72%(50/57)的排卵率和35.09%(20/57)的妊娠率高于对照组的64.91%(37/57)和17.54%(10/57),差异有统计学意义(P<0.05);观察组7.02%(4/57)的不良反应发生率与对照组的3.51%(2/57)相较,差异无统计学意义(P>0.05)。结论二甲双胍联合炔雌醇环丙孕酮可改善PCOS不孕症患者雌孕激素水平,促进卵泡发育,提高排卵和妊娠率,安全有效。

【Objective】To observe the effects of metformin combined with ethinylestradiol cyproterone on estrogen,progesterone,ovulation rate and pregnancy rate in infertility patients with polycystic ovary syndrome(PCOS).【Methods】A total of 114 patients with PCOS infertility admitted to our hospital from January 2017 to November 2018 were divided into observation group(n=57,treated with metformin combined with ethinylestradiol cyproterone)and control group(n=57,treated with ethinylestradiol cyproterone).After three cycles of treatment,estrogen,progesterone,follicular development,ovulation rate,pregnancy rate and safety were compared.【Results】After three cycles of treatment,the levels of estradiol(E2)and folliclestimulating hormone(FSH)in the two groups were higher than those before treatment,and luteotropic hormone(LH)was lower than those before treatment,with statistical significance(P<0.05).The levels of E2 and FSH in the observation group were higher than those in the control group after three cycles of treatment(P<0.05),and the levels of LH were lower than those in the control group(P<0.05);after three cycles of treatment,the number of mature follicles in the observation group was higher than that in the control(P<0.05),there was no significant difference in the diameter of mature follicles and endometrial thickness between the two groups(P>0.05);after three cycles of treatment,the ovulation rate[87.72%(50/57)]and the pregnancy rate[35.09%(20/57)]in the observation group were higher than those in the control group[64.91%(37/57)and 17.54%(10/57)],and the differences were significant(P<0.05);the adverse reaction rate in the observation group[7.02%(4/57)]was higher than that in the control group[3.51%(2/57)](P<0.05)with no significant difference(P>0.05).【Conclusion】Metformin combined with ethinylestradiol cyproterone can improve the estrogen and progesterone levels,promote follicular development,improve ovulation and pregnancy rates in PCOS infertility patients,and is safe and effective.