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目的探讨实施供精人工授精前炔雌醇环丙孕酮片(达英-35)预处理对提高多囊卵巢综合征(PCOS)患者妊娠成功率的作用。方法 100例PCOS患者随机分成两组:(1)治疗组(44例),先口服达英-35共3个月,在下一个治疗周期采用克罗米芬加绝经期尿促性素(HMG)促排卵,在排卵前48 h内和排卵后12 h内,进行供精人工授精;(2)对照组(56例),在治疗周期直接采用克罗米芬加尿促性素促排卵,同法行供精人工授精。通过治疗前后内分泌激素值、子宫内膜厚度、HMG用量及每周期平均促卵泡数、供精人工授精结局评价达英-35预处理后人工授精的效果。结果治疗组使用达英-35后的血促黄体生成素(LH)浓度、LH/卵泡刺激素(FSH)比值明显较治疗前降低,并且低于对照组,差异有统计学意义(P<0.05);治疗组促卵泡数、取消周期数、卵泡过度刺激征(OHSS)发生率低于对照组(P<0.01),临床妊娠率高于对照组,流产率低于对照组(P<0.05)。结论 PCOS患者行供精人工授精前使用达英-35预处理,不仅增加了促排卵药物的敏感性,提高了卵泡质量,使人工授精的妊娠成功率明显增加,而且降低了OHSS的发生风险,减少了取消的周期数,减轻了患者负担。
Objective To investigate the effect of pretreatment of ethinyl estradiol cyproterone tablets (Da Ying-35) on the pregnancy success rate in patients with polycystic ovary syndrome (PCOS) before artificial insemination. Methods 100 patients with PCOS were randomly divided into two groups: (1) the treatment group (44 cases), the first oral administration of Ying -35 for 3 months in the next treatment cycle with clomiphene citrate menopause urinary hormone (HMG) ovulation , Within 48 h before ovulation and within 12 h after ovulation, for artificial insemination; (2) control group (56 cases), in the treatment cycle directly with clomiphene citrate and urinary gonadotropin to promote ovulation, Artificial insemination. Through the treatment before and after the endocrine hormones, endometrial thickness, the amount of HMG and the average number of follicles per cycle, artificial insemination for evaluation of the results of artificial insemination Delta-35 pretreatment results. Results Compared with the control group, the LH and follicle stimulating hormone (FSH) levels in the treatment group were significantly lower than those in the control group (P <0.05) ). The incidence of ovarian follicles, canceration cycles and ovarian hyperstimulation syndrome (OHSS) in treatment group were lower than those in control group (P <0.01), clinical pregnancy rate was higher than that in control group, abortion rate was lower than that in control group (P <0.05) . Conclusion Pretreatment with da-Ying-35 before artificial insemination in patients with PCOS not only increases the sensitivity of ovulation induction drugs and improves the quality of follicles, but also significantly increases the pregnancy success rate of artificial insemination and reduces the risk of OHSS. Reduce the number of cycles to cancel, reducing the burden on patients.