两种特殊类型排卵障碍的超声监测和促排卵治疗疗效观察

发布时间：2018-10-16 17:22

【摘要】：目的:了解正常排卵、小卵泡排卵以及未破裂卵泡黄素化患者的临床特征及观察后两者经阴道B超再次监排情况和促排卵治疗效果。方法:回顾性分析了正常排卵组(258例)、小卵泡排卵组(65例)及未破裂卵泡黄素化组(27例)患者年龄、排卵前卵泡大小和基础性激素水平差异,观察了后两组排卵障碍患者经阴道B超再次监排情况。并对两次监排结果一致的58例小卵泡排卵和25例未破裂卵泡黄素化患者进行克罗米芬促排卵治疗,分别观察了这两种排卵障碍患者的正常排卵率及临床妊娠率。结果:正常排卵组、小卵泡排卵组和未破裂卵泡黄素化组患者平均年龄、基础性激素水平均无显著性差异。三组间排卵前卵泡最大平均径线有显著性差异(F=117.9,P0.01)。小卵泡排卵和未破裂卵泡黄素化的发生率分别为18.57%和7.71%。两者再次监排后,再发率分别为89.23%和92.59%。经克罗米芬促排卵联合黄体支持治疗后,小卵泡排卵组和未破裂卵泡黄素化组正常排卵率分别为70.69%和80%,临床妊娠率分别为29.31%和48%。结论:年龄、基础性激素水平不能预测是否正常排卵,经阴道B超监测是诊断小卵泡排卵以及未破裂卵泡黄素化的直观方法。不经过治疗两者再发率高,促排卵治疗联合黄体支持是治疗小卵泡排卵以及未破裂卵泡黄素化的有效方法。
[Abstract]:Objective: to investigate the clinical features of normal ovulation, small follicle ovulation and unruptured follicular luteinization, and to observe the re-monitoring of ovulation and the effect of ovulation promotion after transvaginal ultrasound. Methods: the age, follicle size and basic sex hormone levels of normal ovulation group (258 cases), small follicle ovulation group (65 cases) and unruptured follicular luteinization group (27 cases) were analyzed retrospectively. The second two groups of patients with ovulation disorder were observed again by transvaginal ultrasonography. The ovulatory effects of clomiphene on 58 cases of follicle ovulation and 25 cases of unruptured follicle luteinization were studied. The normal ovulation rate and clinical pregnancy rate of these two kinds of ovulation disorders were observed. Results: there was no significant difference in age and basic sex hormone level in normal ovulation group, small follicle ovulation group and unruptured follicular luteinized group. There was significant difference between the three groups in the mean maximum diameter of follicle before ovulation (F _ (117.9) P _ (0.01). The incidence of follicular ovulation and unruptured follicle luteinization was 18.57% and 7.71%, respectively. The recurrence rates were 89.23% and 92.59%, respectively. After treatment with clomiphene ovulation and luteal support, the normal ovulation rates of small follicle ovulation group and unruptured follicular luteinization group were 70.69% and 80%, respectively. The clinical pregnancy rates were 29.31% and 48%, respectively. Conclusion: age and basic sex hormone level can not predict whether ovulation is normal or not. Transvaginal B-mode ultrasonography is an intuitive method to diagnose ovulation of small follicles and luteinization of unruptured follicles. Ovulation therapy combined with luteal support is an effective method for the treatment of ovulation and luteinization of unruptured follicles.
【作者单位】：武汉市第一医院生殖医学中心;
【分类号】：R711.6

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