丹参酮联合GnRH-a垂体降调节用于多囊卵巢综合征合并代谢障碍者冻融胚胎移植的临床效果

Clinical effect of tanshinone combined with GnRH-a pituitary down regulation for treating women with polycystic ovary syndrome and metabolic disorder during freeze thawing embryo transplantation

目的:探讨丹参酮联合促性腺释放激素激动剂(GnRH-a)垂体降调节在多囊卵巢综合征(PCOS)合并代谢障碍者冻融胚胎移植的临床效果。方法:将150例行冻融胚胎移植(FET)的PCOS合并代谢障碍患者分为丹参酮组、垂体降调节组和联合组,比较3组血清生殖激素和糖脂代谢指标水平,子宫内膜容受性以及临床妊娠结局。结果:3组基础血清生殖激素和糖脂代谢指标无差异(P>0.05)。联合组内膜转化日、FET移植前1天血清卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E;)和睾酮(T)水平明显低于丹参酮组和垂体降调节组(P<0.05);内膜转化日丹参酮组和联合组空腹血糖(FBG)、胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL)水平降低(P<0.05),联合组FBG、TC、TG和LDL水平显著低于丹参酮组(P<0.05);联合组ET日子宫内膜厚度、A型内膜占比以及临床妊娠率明显大于丹参酮组和垂体降调节组(P<0.05)。结论:丹参酮联合GnRH-a垂体降调节能进一步改善PCOS女性代谢异常,降低雄激素,提高子宫内膜容受性及改善妊娠结局。

Objective:To explore the clinical effect of tanshinone combined with GnRH-a pituitary down regulation for treating women with polycystic ovary syndrome(PCOS)during freeze thawing embryo transplantation.Methods:150 women with PCOS during freeze thawing embryo transplantation(FET)were divided into group A(women given polycystic only),group B(women given GnRH-a pituitary down regulation only),and group C(women given tanshinone combined with GnRH-a pituitary down regulation).The levels of serum reproductive hormone,and glucose and lipid metabolism index,the endometrial receptivity,and the clinical pregnancy outcomes of the women were compared among the three groups.Results:There were no significant different in the levels of serum basics reproductive hormone,and glucose and lipid metabolism index of the women among the three groups(P>0.05).The levels of serum follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E;),and testosterone(T)of the women on the endometrial transformation day and 1 day before FET in group C were significantly lower than those of the women in group A and group B(P<0.05).The levels of fasting blood glucose(FBG),cholesterol(TC),triglyceride(TG),and low density lipoprotein(LDL)of the women in group A and group C on the endometrial transformation day had decreased significantly(P<0.05),and the levels of FBG,TC,TG and LDL of the women in group C were significantly lower than those of the women in group B(P<0.05).The endometrial thickness,the ratio of endometrial type A,and the clinical pregnancy rate of the women in group C on the ET day were significantly higher than those of the women in group A and group B(P<0.05).Conclusion:Tanshinone combined with GnRH-apituitary down-regulation can further improve metabolic abnormalities of the women with PCOS,reduce their serum androgen level,increase their endometrial receptivity,and improve their pregnancy outcomes.