不同促排卵方案对多囊卵巢综合征患者子宫及卵巢血流的影响

发布时间：2018-04-17 14:23

本文选题：多囊卵巢综合征 + 促排卵　；参考：《中国现代医学杂志》2015年23期

【摘要】：目的探讨多囊卵巢综合征(PCOS)伴不孕患者多种促排卵药物治疗前后子宫及卵巢血流动力学变化。方法对该院行供精人工授精的150例PCOS患者,在自然周期月经的第2~3、16~18和20~25天及不同促排方案[克罗米芬(CC)组、CC+人绝经期促性腺激素(HMG)组、来曲唑(LE)组、LE+HMG组、HMG组]的人绒毛膜促性腺激素(HCG)注射日行阴道彩色多普勒超声检查,测量子宫内膜厚度、形态,内膜血流、子宫和卵巢动脉血流收缩期峰值血流速度(PSV)及阻力指数(RI)等参数,然后对不同月经时间、促排前后、不同促排方案间妊娠组与非妊娠组的相关参数进行比较。结果 PCOS患者自然周期子宫、卵巢动脉血流PSV、RI值等无周期性变化;使用促排卵药物后子宫内膜厚度、子宫内膜A型率、子宫内膜A型血流率、子宫内膜下、卵巢及子宫动脉血流的PSV等明显增加,子宫内膜下、卵巢及子宫动脉血流的RI明显降低;5种促排卵方案中,LE+HMG组方案子宫内膜A型血流率、子宫内膜下血流PSV值明显高于其余4组,且该组的妊娠率最高;妊娠患者HCG注射日子宫内膜下、子宫及卵巢动脉血流PSV明显高于非妊娠患者,但RI指数则明显低于非妊娠患者。结论 1PCOS患者使用促排卵药物,使患者恢复排卵的同时亦能改善子宫内膜容受性,其中以LE+HMG方案最佳;2HCG注射日子宫内膜下、子宫及卵巢动脉血流的改善有助于提高人工授精的成功率。
[Abstract]:Objective to investigate the changes of uterine and ovarian hemodynamics in patients with polycystic ovary syndrome (PCOS) with infertility.Methods one hundred and fifty patients with PCOS undergoing artificial insemination for spermatogenesis in our hospital were treated with CC human menopausal gonadotropin (CC) group.Human chorionic gonadotropin (HCG) of letrozolide group (LE HMG group) was examined by color Doppler ultrasonography on the day of injection. The thickness, morphology and blood flow of endometrium were measured.The parameters of peak systolic velocity (PSV) and resistance index (RI) of uterine and ovarian arteries were compared between pregnancy group and non-pregnancy group.Results there were no periodic changes in the blood flow of uterine and ovarian arteries in PCOS patients, including endometrial thickness, endometrial type A rate, endometrial type A blood flow rate, subendometrial blood flow rate, etc.The PSV of ovarian and uterine artery blood flow increased obviously. The RI of ovarian and uterine artery blood flow under endometrium significantly decreased the type A blood flow rate of endometrium in five ovulation-promoting regimens.The PSV value of the subendometrial blood flow was significantly higher than that of the other four groups, and the pregnancy rate was the highest in the group, and on the day of HCG injection, the blood flow PSV of uterine and ovarian arteries in the pregnant patients was significantly higher than that in the non-pregnant patients, but the RI index was significantly lower than that in the non-pregnant patients.Conclusion Ovulation-promoting drugs used in patients with 1PCOS can restore ovulation and improve endometrial receptivity, among which le HMG regimen is the best for subendometrial subendometrium on the day of injection.The improvement of uterine and ovarian artery blood flow is helpful to improve the success rate of artificial insemination.
【作者单位】：江西省南昌市生殖医院;
【基金】：江西省卫生厅科技计划项目(No:20112045)
【分类号】：R711.75

【参考文献】