不同促排卵方案联合宫腔内人工授精的疗效观察

目的探讨克罗米酚（CC）、来曲唑（LE）以及人绝经期促性腺激素（HMG）3种促排卵方案联合官腔内人工授精（IUI）的临床妊娠结局。方法选择2011年10月至2012年9月因排卵障碍、多囊卵巢综合征、卵泡发育不良及卵巢储备功能下降等原因在泰州市人民医院接受IUI治疗的98例不孕症患者（共计157个治疗周期）为研究对象，并对其临床病历资料进行回顾性分析。按照不同的促排卵药物，将其分别纳人CC组（n=36，共计60个治疗周期）、LE组（n=34，共计55个治疗周期）和HMG组（n=28，共计42个治疗周期）。比较3组患者在肌肉注射人绒毛膜促性腺激素（hCG）日的优势卵泡数和大小、注射hCG日子宫内膜厚度、临床妊娠率、多胎率、自然流产率及重度卵巢过度刺激综合征发生率等。本研究遵循的程序符合泰州市人民医院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象的知情同意，并与之签署临床研究知情同意书。结果LE组患者注射hCG日子宫内膜厚度显著高于CC组和HMG组，组间比较，差异均有统计学意义（t=9．329，-6．256；P〈0．05），CC组和HMG组患者注射hCG日子宫内膜厚度比较，差异无统计学意义（t=1．304，P〉0．05）。HMG组患者在注射hCG日优势卵泡数与CC组和LE组比较，差异有统计学意义（t=-1．137，-1．18；P〈0．05），而CC组和LE组患者注射hCG日优势卵泡数比较，差异无统计学意义（t=0．704，P〉0．05）。结论LE在改善子宫内膜厚度上优于CC和HMG，而HMG在促进卵泡发育方面优于CC和LE。

Therapeutic Efficacy of Promoting Ovulation Combining Intrauterine Insemination on Infertility

Objective To discuss the clinical pregnancy outcomes of three methods Clomiphene （CC）, Letrozole （LE） and human menopausal gonadotropin （HMG）] of promoting ovulation combining intrauterine insemination （IUI） on infertility. Methods From October 2011 to September 2012, a total of 98 cases with 157 treatment cycles, due to ovulation disorders, polycystic ovary syndrome, follicular dysplasia and other reasons, who were received IUI treatment in Taizhou People＇s Hospital were retrospectively analyzed. According to different ovarian simulation potocols, they were incorporated into three groups ： CC group （n= 36,60 treatment cycles）, LE group （n = 34, 55 treatment cycles） and HMG group （n= 28, 42 treatment cycles）. There were no significant differences on age and duration of infertility among three groups （P 〉 0. 05）. The follicle number, size and endometrial thickness on the day of intramuscular injection of human chorionic gonadotropin （hCG）, and clinical pregnancy rates, multiple pregnancy rates and abortion rates among three groups were compared. In this study, the procedure followed in line with Taizhou People＇s Hospital Ethics Committee to develop a standard human trials to obtain approval of the committee, grouping the consent of the subject＇s consent and with the signing of informed consent in clinical research. Results The endometrial thickness on the day of intramuscular injection of hCG of LE group was higher than that of CC group and HMG groups（t= -9. 329, P〈0.05; t=-6. 256,P〈0.05）, but there was no statistically significant difference between CC group and HMG group （t= 1. 304,P〉0.05）. The follicle number of HMG group on the day of intramuscular injection of hCG was much more than that of CC group and LE group （t=-1. 137, P〈0.05; t=-1. 187, P〈0.05）, while there was no significant difference between CC group and LE group （t=0. 704, P〉0.05）. Conclusions LE was superior to CC and HMG in the aspect of improving endometrial thickness, wh