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目的:探讨克罗米芬联合促卵泡素治疗多囊卵巢综合征(PCOS)合并不孕的临床疗效。方法:对51例PCOS合并不孕患者进行克罗米芬促排卵联合促卵泡素治疗,当优势卵泡直径>18 mm时予以人绒毛膜促性腺激素(HCG)肌肉注射,排卵后采用黄体孕酮胶丸支持治疗,记录月经周期第8天优势卵泡直径、应用HCG日子宫内膜厚度、最大卵泡直径、直径>15 mm的卵泡数、排卵率、妊娠率。结果:51例患者月经周期第8天卵泡直径为(0.81±0.11)cm,优势卵泡直径>18 mm时子宫内膜厚度为(0.93±0.14)cm,最大卵泡直径为(1.97±0.14)cm,直径≥1.5 cm个数为(1.56±0.97)个,51例患者平均排卵个数为(1.39±0.69)个,其中47例排卵,排卵率为92.2%,10例妊娠,妊娠率为19.6%。所有患者均完成治疗,其中2例患者发生轻度卵巢过度刺激综合征,1例患者注射HCG后出现黄素化综合征。结论:在PCOS合并不孕患者克罗米芬促排卵治疗中,于月经周期第8天应用尿促卵泡素,有利于获得如自然周期的单卵泡发育排卵。
Objective: To investigate the clinical efficacy of clomiphene in combination with follitropin in the treatment of polycystic ovary syndrome (PCOS) with infertility. Methods: Fifty-one patients with PCOS complicated with infertility were treated with clomiphene and ovarian follicle stimulating hormone. When the dominant follicle diameter was> 18 mm, human chorionic gonadotropin (HCG) was intramuscularly injected. After ovulation, progesterone capsules , The dominant follicle diameter was recorded on the 8th day of the menstrual cycle, the thickness of the endometrium on HCG day, the diameter of the largest follicle, the number of follicles> 15 mm in diameter, ovulation rate and pregnancy rate were recorded. Results: In the 51 patients, the diameter of the follicles was (0.81 ± 0.11) cm on the 8th day of the menstrual cycle, the thickness of the endometrium was (0.93 ± 0.14) cm and the diameter of the largest follicle was (1.97 ± 0.14) cm, The number of ovulation≥1.5 cm was (1.56 ± 0.97). The average number of ovulation in 51 patients was (1.39 ± 0.69), of which 47 cases were ovulation and the ovulation rate was 92.2%. The pregnancy rate was 19.6% in 10 cases. All patients completed the treatment, of which 2 patients had mild ovarian hyperstimulation syndrome and 1 patient had luteinized syndrome after injection of HCG. Conclusions: Clomiphene is an effective ovulation inducing therapy for PCOS patients with infertility. Urinary follicle stimulating hormone is applied on the 8th day of the menstrual cycle, which is conducive to obtain single ovarian follicle developmental ovulation such as natural cycles.