炔雌醇环丙孕酮片联合枸橼酸氯米芬片治疗多囊卵巢综合征不孕症的效果及对子宫内膜容受性、排卵情况及妊娠的影响

Effects of ethinylestradiol and cyproterone acetate tablets combined with clomiphene citrate tablets in the treatment of polycystic ovary syndrome infertility and their influence on endometrial receptivity,ovulation condition and pregnancy

目的探讨炔雌醇环丙孕酮片联合枸橼酸氯米芬片治疗多囊卵巢综合征(PCOS)不孕症的效果及对子宫内膜容受性、排卵情况和妊娠的影响。方法选取2021年3月至2022年3月安徽医科大学附属安庆市第一人民医院收治的90例PCOS不孕症患者作为研究对象。根据随机数字表法分为对照组和观察组,每组45例。对照组单用枸橼酸氯米芬片治疗,观察组在对照组基础上联合炔雌醇环丙孕酮片治疗。比较两组临床疗效、子宫内膜容受性、排卵情况及妊娠结局。结果观察组总有效率高于对照组(P<0.05);治疗后,两组子宫内膜厚度较治疗前均升高,且观察组高于对照组(P<0.05);治疗后,两组血流搏动指数(PI)和阻力指数(RI)较治疗前均减小,且观察组小于对照组(P<0.05);治疗后,观察组成熟卵泡数量较对照组更少(P<0.05);治疗后,两组最大卵泡直径和排卵率比较,差异无统计学意义(P>0.05);随访12个月,观察组临床妊娠率较对照组更高,不良妊娠结局率较对照组更低(P<0.05)。结论采用炔雌醇环丙孕酮片联合枸橼酸氯米芬片治疗PCOS不孕症患者,可显著提升治疗效果,增强子宫内膜容受性,有效促进排卵并改善妊娠结局。

Objective To investigate the effects of ethinylestradiol and cyproterone acetate tablets combined with clomiphene citrate tablets in the treatment of polycystic ovary syndrome(PCOS)infertility,and their influence on endometrial receptivity,ovulation condition and pregnancy.Methods A total of 90 patients with PCOS infertility who were admitted to Anqing First People's Hospital of Anhui Medical University from March 2021 to March 2022 were selected as the study objects.They were divided into control group and observation group according to the random number table method,with 45 cases in each group.The control group was treated with clomiphene citrate tablets alone,and the observation group was combinedly treated with ethinylestradiol and cyproterone acetate tablets on the basis of control group.Clinical efficacy,endometrial receptivity,ovulation condition,and pregnancy outcomes in the two groups were compared.Results The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,endometrial thickness of both groups increased,and endometrial thickness of the observation group was larger than that of the control group(P<0.05).After treatment,pulsatility index(PI)and resistance index(RI)in both groups decreased and those in the observation group were lower than those in the control group(P<0.05).After treatment,number of mature follicle in the observation group was lower than that in the control group(P<0.05).After treatment,there were no statistically significant difference in the maximum follicle diameter and ovulation rate between the two groups(P>0.05).After 12 months of follow-up,the clinical pregnancy rate in the observation group was higher than that in the control group,and the incidence of adverse pregnancy outcomes was lower than that in the control group(P<0.05).Conclusions Applying ethinylestradiol and cyproterone acetate tablets combined with clomiphene citrate tablets in the treatment of PCOS infertility can significantly improve the therapeutic effect,enhance endometrial receptivity,effectively promote ovulation and improve pregnancy outcomes.