达英-35联合诱导排卵及卵泡穿刺治疗多囊卵巢综合征性排卵障碍的效果

目的:观察达英-35联合诱导排卵及卵泡穿刺治疗多囊卵巢综合征性排卵障碍患者的临床妊娠率。方法:多囊卵巢综合征性排卵障碍的不孕症患者92例随机分为两组,达英-35治疗3～6个周期,睾酮基本降至正常后,继续用克罗米芬或尿促性素诱导排卵治疗,近卯泡发育成熟肌注HCG 5 000U,无穿刺组共47例次日同房,穿刺组共45例次日卵泡穿刺后同房。结果:无穿刺组周期排卵率为63.5%,临床妊娠21例,临床妊娠率为44.7%(21/47),三胎妊娠3例,中重度卵巢过度刺激综合征(OHSS)4例;穿刺组周期排卵率100.0%,临床妊娠31例,临床妊娠率为68.9%(31/45),中度卵巢过度刺激综合征1例,无多胎及重度卵巢过度刺激征出现,停用穿刺治疗后6个月内,继续有4例妊娠。结论:达英-35联合诱导排卵及卵泡穿刺治疗多囊卵巢综合征(PCOS)性排卵障碍,不仅可以提高排卵率和临床妊娠率,而且可以相应降低卵巢过度刺激的风险。

Effects of diane-35 combined with ovulation induction and follicular puncture on polycystic ovary syndrome-related anovulatory failure

Objective:To observe the clinical pregnancy rate of patients with polycystic ovary syndrome(PCOS)-related anovulatory failure treated by diane-35 combined with ovulation induction and follicular puncture.Methods:92 patients with PCOS-related anovulatory failure were divided into two groups,then treated by diane-35 for 3～6 cycles.When testosterone level decreased down to normal level,continuity administration of clomiphene or menotropins was given.When follicles nearly became mature,5 000 U of HCG were given. Non-puncture group had sexual intercourse in the second day,while puncture group underwent follicular puncture before sexual intercourse in the second day.Results:The ovulation rate in per cycle and pregnancy rate in non-puncture group were 63.5%and 44.7% (21/47),respectively,including 3 cases of triplet pregnancy and 4 cases of OHSS in non-puncture group.The ovulation rate in per cycle and pregnancy rate in puncture group were 100.0%and 68.9%(31/45),respectively,including 1 case of OHSS in puncture group,after termination of follicular puncture,4 patients got pregnancy.Conclusion:Diane-35 combined with ovulation induction and follicular puncture can improve ovulation rate and pregnancy rate of patients with PCOS-related anovulatory failure,while multiple pregnancy rate and OHSS rate were reduced significantly.