治疗多囊卵巢综合征患者的不同方法比较

摘要

目的 比较不同促排卵方案治疗多囊卵巢综合征(PCOS)不孕症患者的临床疗效及其安全性.方法 将2007年9月-2010年7月在我科就医的PCOS不孕患者108例,随机分为CC组、HMG组、CC+HMG组和LE组,每组27例,监测用药期间四组患者的促排卵情况、卵泡发育情况、子宫内膜厚度及其不良反应.结果 CC组有较高的排卵率,较低的妊娠率,子宫内膜厚度最薄,多胎妊娠率和OHSS风险较低;HMG组具有高排卵率、妊娠率,但多胎妊娠率和OHSS发生的危险性最高;LE组有较低排卵率、妊娠率,卵泡最小,多胎妊娠率和OHSS发生的危险性较低;CC+HMG组具有高排卵率、妊娠率,多胎妊娠率和OHSS发生的危险性较高.结论 四种促排卵法都有很好的促排卵作用,HMG和CC+HMG的妊娠率要高于LE和CC(P<0.05),但易导致OHSS和多胎妊娠,LE无论对卵泡生长还是对内膜生长都比较好且副作用低.但LE是否有潜在的胚胎致畸性有待进一步考证.%Objective To compare the efficacy and safety of different therapies for sterile women with polycystic ovary syndrome ( PCOS ). Methods 108 sterile women with PCOS who had had medical visits during September 2007 and July 2010 were randomized to CC group, HMG group, CC/HMG group, or LE group, 27 women for each group. Ovulation induction, follicular development, endometrial thickness, and adverse reactions were observed. Results CC group had a higher rate of ovulation but lower rate of pregnancy, thinnest endometrial thickness, and a lower multiple pregnancy rate and OHSS risks. HMG group had higher rates of ovulation and pregnancy, and highest risks of multiple pregnancy and OHSS. LE group had lower rates of ovulation and pregnancy, smallest size of follicles, and lower risks of multiple pregnancy and OHSS. CC/HMG group had higher rates of ovulation, pregnancy, multiple pregnancy, and OHSS risk. Conclusions Four therapies have positive effects on ovulation. HMG and CC plus HMG could result in a higher rate of pregnancy and higher risks of multiple pregnancy and OHSS. LE has a positive effect on the development of follicles and endometrium,but has possible teratogenicity.