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目的:探讨阴道超声监测卵泡发育对排卵障碍不孕症患者的临床应用价值。方法:45例不孕症患者中18例用氯米芬促排卵,14例用尿促性素促排卵,13例用氯米芬和尿促性素序贯应用促排卵,患者于月经第9天起阴道超声监测卵泡发育和子宫内膜厚度,并根据监测结果调整药物剂量,诱发排卵指导同房,排卵后2周进行妊娠随访,随访至妊娠3个月。结果:45例患者子宫附件均正常者33例,多囊卵巢7例,子宫肌瘤4例,附件混合性包块1例。45例患者卵泡发育成熟并排卵31例,排卵率为68.9%,小卵泡排卵2例,卵泡不发育6例,未破裂卵泡黄素化综合征4例,卵巢过度刺激综合征2例。生化妊娠1例,临床妊娠9例,临床妊娠率为29.0%,其中1例于停经45天时自然流产。结论:经阴道超声监测卵泡发育和排卵准确、直观,对不孕症病因的诊断和指导治疗均有重要作用。
Objective: To investigate the clinical value of vaginal ultrasound in detecting follicular development in infertile patients with ovulation disorders. Methods: Among 45 infertility patients, 18 cases were induced ovulation with clomiphene, 14 cases were ovulation induced by urinary procyanidin, 13 cases were ovulation stimulated sequentially with clomiphene and urinary ghrelin, Day vaginal ultrasound monitoring of follicular development and endometrial thickness, and adjust the dose based on the monitoring results to induce ovulation induction of intercourse, 2 weeks after ovulation pregnancy follow-up, follow-up to 3 months of pregnancy. Results: 45 cases of normal uterine attachment were 33 cases, polycystic ovary in 7 cases, uterine fibroids in 4 cases, annexes mixed mass in 1 case. Forty-five patients had ovarian follicles mature and ovulated in 31 cases, with an ovulation rate of 68.9%, two cases of small follicle ovulation, six follicles undeveloped, four cases of unruptured follicular luteinizing syndrome and two cases of ovarian hyperstimulation syndrome. 1 case of biochemical pregnancy, 9 cases of clinical pregnancy, the clinical pregnancy rate was 29.0%, of which 1 case of spontaneous abortion 45 days after menopause. Conclusion: Transvaginal ultrasound monitoring of ovarian follicle development and ovulation accurate and intuitive diagnosis and treatment of infertility causes have an important role.