多囊卵巢综合征不孕患者未成熟卵泡抽吸术的疗效分析

目的:探讨对克罗米芬抵抗的多囊卵巢综合征(PCOS)不孕患者在超声引导下行小卵泡抽吸术(IMFA)的治疗效果。方法:将42例PCOS合并克罗米芬(CC)抵抗的不孕患者,随机分为A组:19例,穿刺前用CC或来曲唑(LE)联合少量hMG促排卵;B组:23例,穿刺前用少量hMG促排卵。在阴道B超引导下进行未成熟卵泡抽吸术(IMFA),观察穿刺前及穿刺后第2周期患者的卵巢基础窦卵泡数(AFC)、抗苗勒氏管激素(AMH)、血中游离睾酮指数(FAI)、黄体生成素与卵泡刺激素的比值(LH/FSH),以及术后并发症、3个月促排卵情况和妊娠率。结果:42例患者治疗时均没有发生卵巢过度刺激综合征(OHSS)。与治疗前比较,穿刺术后A、B组AFC显著减少,AMH、FAI和LH/FSH显著降低(P<0.01)。A、B组间比较,FAI、LH/FSH、排卵率和妊娠率无统计学差异(P>0.05)。A、B组共21例妊娠,妊娠率为50%。42例患者均没有发生出血、感染、OHSS。结论:IMFA治疗克罗米芬抵抗的PCOS不孕患者有较好的疗效,本方法安全、有效。

Clinical Efficacy of Treating Infertile Women with Polycystic Ovary Syndrome by Using Ultrasound-guided Immature Follicle Aspiration

Objective: To investigate the clinical efficacy of treating infertile women with polycystic ovary syndrome(PCOS) by using ultrasound-guided immature follicle aspiration(IMFA).Methods: A total of 42 infertile women with PCOS and clomiphene(CC) resistance were randomly divided into two groups.Group A: 19 cases were induced ovulation with CC or letrozole(LE) combined with small amount of hMG before puncture.Group B: 23 cases were induced ovulation with a small amount of hMG before puncture.After IMFA,endocrine function,ovulation instance and pregnancy rate within 3 months were observed.Results: Ovary hyperstimulation syndrome did not occur in all cases.Compared with pre-treating,free androgen index(FAI) in blood,anti-Müllerian hormone(AMH),ratio of luteinizing hormone(LH) and follicle stimulating hormone(FSH) were significantly lower(P<0.01),and rates of ovulation and pregnancy were significantly improved after IMFA(P<0.01).Conclusion: IMFA would have a good clinical efficacy for treating infertile women with PCOS,and would be safe.