口服避孕药结合促性腺激素释放激素激动剂在多囊卵巢综合征超排卵中对卵泡液血管内皮生长因子的影响

目的通过测定超排卵过程中采用口服避孕药（OC）结合GnRH-a的PCOS患者VEGF水平，对OHSS发生的影响。方法对接受体外受精-胚胎移植（IVF—ET）或单精子胞浆内注射（ICSI）术的29例PCOS患者采用长方案超促排卵，其中15例在COH前采用OC＋GnRH-a，14例仅用GnRH-a做为对照组，选取两组中注射hCG日E2〉14680pmol／L的PCOS患者11例与14例。收集取卵日卵泡液，用酶联免疫吸附法检测VEGF水平，记录hCG日至ET后4d中度及中度以上卵巢过度刺激综合征（OHSS）的发生情况。结果OC＋GnRH-a组在取卵日卵泡液VEGF的平均水平显著性低于对照组（P=0．024），OC＋GnRH-a组的中度及中度以上OHSS发生率低于对照组，但差异无显著性（P=0．110）。结论OC＋GnRH-a在PCOS患者超排卵中，能够降低卵巢局部VEGF水平，但未改变中度及中度以上OHSS的发生率。

Study on effect of the protocol with oral contraceptive(OC) and gonadotrophin releasing hormone against ( GnRH-a) on follicular fluid( FF) vascular endothelial growth factor (VEGF) concentration in patients with polycystic ovarian syndrome(PCOS) undergoing controlled ovarian hyperstimulation(COH)

Objective The aim of this study is to investigate the effect of the protocol with oral contraceptive（OC） and gonadotrophin releasing hormone agonist （GnRH-a） on follicular fluid（FF） vascular endothelial growth faetor（VEGF） concentration in patients with polycystic ovarian syndrome （PCOS） undergoing controlled ovarian hyperstimulation（COH）. Method Patients with PCOS were enrolled from IVF - ET or ICSI program. OC pills were taken for 18 days in the OC ＋ GnRH - a group followed by GnRH - a, which was overlapped with the final day of OC administration. All patients underwent a long-protocol regimen. FF was collected at the time of oocyte retrieval （OR） from subjects whose serum E2 on the day of hCG administration more than 14680pmol/L. This study included 11 patients in the OC ＋ GnRH - a group and 14 patients in the control group. FF samples were analysed for VEGF concentrations by ELISA. Occurrences of OHSS were recorded. Results The FF levels of VEGF in the OC ＋ GnRH - a group at the time of OR were significantly lower than those from the controls. There were no statistically significant differences between the two groups in the proportion of patents who developed OHSS. Conclution The protocol with OC and GnRH- a decreases FF VEGF levels in patients with PCOS undergoing COH, but it doesn＇t change the incidence of OHSS of medium degree or above.