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目的观察多囊卵巢综合征(PCOS)合并不孕患者采用妈富隆及二甲双胍联合预处理的临床疗效。方法将符合PCOS诊断的不孕患者264例分为两组:A组,136例,共计210个周期,采用口服妈富隆、二甲双胍联合预处理,再用克罗米芬(CC)+人尿促性腺激素(HMG)促排卵方案治疗;B组,128例,共计194个周期,直接用CC+HMG促排卵方案治疗。比较两组用药前后血清黄体生成素(LH)、LH/促卵泡素(FSH)、睾酮(T)、空腹胰岛素(FIns)的变化,以及周期排卵率和妊娠率。结果两组治疗后血清LH、LH/FSH、T、FIns均见下降,但A组各指标的下降程度显著大于B组(P<0.05)。A组周期排卵率显著高于B组(83%vs.37%)(P<0.05),A组周期妊娠率显著高于B组(45%vs.11%)(P<0.05)。结论采用妈富隆及二甲双胍联合预处理治疗PCOS不孕,可更有效地改善胰岛素抵抗,降低血清LH、LH/FSH、T水平,并且提高PCOS不孕患者的排卵率及妊娠率。
Objective To observe the clinical effect of pretreatment with Marvelon and metformin in patients with polycystic ovary syndrome (PCOS) and infertility. Methods Two hundred and sixty-four infertile patients who were diagnosed as PCOS were divided into two groups: group A (136 cases), with a total of 210 cycles. The patients were treated with oral Marvlon and metformin combined with pretreatment with clomiphene citrate (CC) + human urogenital gonadotropin (HMG) ovulation induction treatment; group B, 128 cases, a total of 194 cycles, direct treatment with ovulation induction CC + HMG program. The changes of serum LH, LH / FSH, FI and FIns before and after treatment were compared, as well as the rate of ovulation and pregnancy. Results The serum levels of LH, LH / FSH, T and FIns decreased after treatment in both groups, but the decrease of each index in group A was significantly greater than that in group B (P <0.05). The ovulation rate in group A was significantly higher than that in group B (83% vs 37%) (P <0.05). The cycle pregnancy rate in group A was significantly higher than that in group B (45% vs. 11%, P <0.05). Conclusions The combination of Marvelon and metformin in the treatment of PCOS infertility can be more effective in improving insulin resistance, reducing serum LH, LH / FSH, T levels, and improve PCOS infertility patients ovulation and pregnancy rates.