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目的分析不明原因不孕患者宫腔内人工授精(IUI)中发生未破裂卵泡黄素化综合征(LUFs)的临床特点,比较LUF周期与正常排卵周期在不同时间各项激素水平及在不同IUI周期LUFs发生情况,探讨LUFs的发病机制。方法对不明原因不孕患者行HMG促排卵IUI治疗140例,228周期为病例组,根据患者是否有排卵分为:未排卵出现LUFs组(A组),正常排卵组(B组),选择因男性因素不孕就诊行自然周期IUI有正常排卵的患者151例对照组(C组),分别在月经周期的第3天、排卵日、LUF日进行性激素测定,对A、B、C组患者不同时间的血清性激素进行比较。对第一周期未孕的不明原因不孕的患者中的88例行第二周期IUI,比较在不同IUI周期时LUF发生情况。结果在排卵日A、B组的FSH、LH和P低于C组(P<0.05)。在LUF日测定的A、B组LH和E2值高于C组(P<0.05)。140例不明原因不孕患者第一周期IUI,29例发生LUFs,发生率为20.71%,对第一周期未孕的不明原因不孕的患者中的88例行第二周期IUI,重复出现LUFs的患者20例,为71.43%。结论围排卵期激素变化可能导致LUFs,促排卵周期LUFs的发生可能与LH峰值偏低或不出现LH/FSH峰有关。在不明原因不孕患者用促排卵IUI周期中LUFs的发生率较高,其发生率可达20.71%,重复治疗周期中LUFs的再次发生率可达71.43%。因此探讨有效方法预防和治疗LUFs在不明原因不孕症治疗尤其是促排卵治疗中有着非常重要的意义。
Objective To analyze the clinical features of unruptured follicular luteinizing syndrome (LUFs) in intrauterine insemination (IUI) in patients with unexplained infertility and to compare the levels of LUFs with those of normal ovulation cycles at different times and LUFs Occurrence, to explore the pathogenesis of LUFs. Methods One hundred and forty-four patients with unexplained infertility were enrolled in this study. One hundred and twenty-eight patients were enrolled in this study. One hundred and eighty-eight patients were enrolled in this study. 228 patients were enrolled in this study. According to whether ovulation occurred, LUFs (group A) Male patients with infertility were randomly divided into three groups: control group (group C), control group (n = 151) and control group (group C). The sex hormones were determined on the day of menstruation, Time of serum sex hormones were compared. Eighty-eight patients with unexplained infertility who were not pregnant in the first cycle underwent IUI for the second cycle, and compared the occurrence of LUF at different IUI cycles. Results On the day of ovulation, FSH, LH and P in group A and group B were lower than those in group C (P <0.05). The values of LH and E2 in group A and group B were higher than those in group C on LUF day (P <0.05). The first cycle of 140 patients with unexplained infertility IUI, 29 cases of LUFs occurred, the incidence was 20.71%, the first cycle of unexplained infertility in patients with unexplained 88 cases of the second cycle of IUI repeat LUFs 20 patients, 71.43%. Conclusions Ovulation hormones may lead to LUFs. The occurrence of LUFs during ovulation induction may be related to the low or no LH / FSH peak. The incidence of LUFs in patients with unexplained infertility was higher than that in patients with ovulation-induced IUI. The incidence of LUFs was 20.71%. The recurrence rate of LUFs was 71.43% in repeated treatment cycles. Therefore, to explore effective methods for the prevention and treatment of LUFs in the treatment of unexplained infertility, especially ovulation induction has a very important significance.