克罗米芬的不同使用时机对优思明预处理多囊卵巢综合征患者妊娠结局的影响

目的探讨枸橼酸氯米芬（克罗米芬）的不同使用时机对优思明预处理多囊卵巢综合征患者妊娠结局的影响。方法对我院2011年4月~2015年4月妇科生殖内分泌、不孕门诊120例多囊卵巢综合征并不孕症优思明治疗3~6个月后LH、FSH、T下降接近正常后，随机分为A、B两组，A组：停用优思明治疗后下月月经第5~9天开始克罗米芬促排卵治疗，治疗3个月；B组：停用优思明治疗后月经第5~9天开始克罗米芬促排卵治疗，治疗3个月。比较两组激素水平、规律月经、排卵率、妊娠率。结果两组激素水平比较无统计学差异（P>0.05）。A组和B组月经规律发生率分别为78.3%、58.3%，两组月经规律发生情况比较差异有统计学意义（χ²=5.546，P<0.05）；A组和B组排卵率分别为78.3%、58.3%，两组排卵情况比较差异有统计学意义(χ²=5.546，P<0.05)；A组和B组妊娠率分别为46.7%、26.7%，两组妊娠情况比较差异有统计学意义（χ²=5.17，P<0.05)。结论优思明治疗多囊卵巢综合征并不孕症，停药第1个月多数可自然排卵，克罗米芬促排卵时间从第2个月开始，能明显提高受孕率。

Influence of the different time of using Clomifene Citrate on patients with polycystic ovary syndrome after pretreatment of Yasmin

ObjectiveTo evaluate different time of using Clomifene Citrate on the clinical outcome of patients with polycystic ovary syndrome after pretreatment of drospirenone and ethinylestradiol tablets(Yasmin). MethodsA toyal of 120 cases in the gynecological endocrinology and infertility clinic of Changan Hospital of Dongguan City from Jan. 2014 to May 2015 who undergone drospirenone and ethinylestradiol tablets for three months to six so as to adjust the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) to the normal were chosen.All cases were randomly divided into observation group(A group) which took Clomifene Citrate for three months at the time of the second menstrual cycle day 5 to day 9 after Yasmin was stopped and control group (B group) which took it for three months at the time of the first. The hormone levels of the patients, incidence of regular menstruation, stimulating ovulation condition and clinical pregnancy outcomes between two groups were compared. ResultsThere were no significant differences in the hormone levels between A group and B group (P>0.05). The incidence of regular menstruation of A group was 78.3% , B group 58.3% . There were significant differences in the incidence of regular menstruation between A group and B group (χ2=5.546, P<0.05).The ovulation rates of A group and B group were 78.3% and 58.3%. There were significant differences in the ovulation rate between A group and B group (χ2=5.546, P<0.05). The pregnancy rates of A group and B group were 46.7% and 26.7%. There were significant differences in the pregnancy rate between A group and B group (χ2=5.17，P<0.05). ConclusionsMost natural ovulation when stop the medicine for first month in Yasmin treatment of polycystic ovary syndrome and infertility. Clomiphene ovulation time can significantly improve the pregnancy rate from the beginning of the second month.