腹腔镜卵巢打孔联合经阴道未成熟卵泡穿刺术治疗难治性多囊卵巢综合征的疗效观察

发布时间：2018-03-18 05:27

本文选题：多囊卵巢综合征　切入点：卵巢打孔术　出处：《中国微创外科杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的评估难治性多囊卵巢综合征(polycystic ovary syndrome,PCOS)行腹腔镜卵巢打孔(laparoscopic ovarian drilling,LOD)联合经阴道未成熟卵泡穿刺术(immature follicle aspiration,IMFA)的疗效。方法 2014年9月~2016年7月,共纳入拟行LOD的难治性PCOS 124例。术前依据患者的意愿,愿意LOD术中同时行IMFA获取未成熟卵者行LOD+IMFA手术,共83例,不愿意同时获卵者仅行LOD手术,共41例。比较2组性激素水平包括促黄体生成素(LH)、雄烯二酮(A)、游离雄激素指数(FAI)、抗缪勒管激素(AMH)等。随访6~12个月,观察自然排卵恢复、促排卵治疗效果及妊娠情况。结果 2组术后第1次月经期LH、A、AMH均比术前显著下降(P0.05),2组之间比较差异无显著性(P0.05)。恢复自然排卵的比例LOD+IMFA组39.8%(33/83),LOD组34.1%(14/41),2组差异无显著性(χ~2=0.367,P=0.544)。对未恢复排卵者进行促排卵治疗,LOD+IMFA组排卵率[78.0%(39/50)]显著高于LOD组[37.0%(10/27),χ~2=12.713,P=0.000]。2组临床妊娠率差异无显著性[44.6%(29/65)vs.32.3%(10/31),χ~2=1.329,P=0.249]。LOD+IMFA组98.8%(82/83)获得成熟卵。结论 LOD+IMFA治疗难治性PCOS安全有效,术中同时获得未成熟卵为患者进行生育力储备。
[Abstract]:Objective to evaluate the efficacy of laparoscopic ovarian ovarian puncture combined with transvaginal immature follicle aspiration in the treatment of refractory polycystic ovary syndrome (PCOS). A total of 124 cases of refractory PCOS were included in this study. According to the wishes of the patients, LOD IMFA was performed in 83 patients who were willing to take IMFA to obtain immature eggs simultaneously during LOD operation, and only LOD operation was performed in those who were unwilling to obtain the eggs simultaneously. The sex hormone levels of the two groups were compared, including luteinizing hormone (LHN), androgen diketone (AJ), free androgen index (FAIU), and anti-Mueller tube hormone (AMH), and were followed up for 6 ~ 12 months to observe the recovery of spontaneous ovulation. Results there was no significant difference between the two groups in the first menstrual period after operation between the two groups. There was no significant difference between the two groups. The rate of recovery of ovulation was 39.8% 33 / 83% low in LOD IMFA group, 34.1T / 41D group. There was no significant difference between the two groups. The ovulation rate in the IMFA group was significantly higher than that in the LOD group [37.00.27%, 12.713% P0.000] .2 there was no significant difference in the clinical pregnancy rate between the two groups [44.62.965 / vs.32.30.10 / 31, 蠂 ~ (2 / 2) 1.329P ~ (0.249)] .LOD IMFA group 98.882% -83%. Conclusion LOD IMFA is safe and effective in the treatment of refractory PCOS. During the operation, immature eggs were obtained simultaneously to reserve fertility for the patient.
【作者单位】：北京大学第三医院生殖医学中心;
【基金】：国家自然科学基金海外及港澳合作基金(31429004) 院内临床重点支持项目(Y67437-10)
【分类号】：R713.6

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