妈富隆治疗耐氯米芬多囊卵巢综合征不孕的临床观察

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1、妈富隆治疗耐氯米芬多囊卵巢综合征不孕的临床观察【摘要】目的观察妈富隆联合延长氯米芬（CC）服药时间或妈富隆联合低剂量FSH-HP开始促排卵方案治疗耐CC多囊卵巢综合征（PCOS）不孕的临床效果。方法选择耐CC的PCOS伴不孕的患者32例，73个治疗周期，随机分为2组。A组：妈富隆＋CC组，16例，38个周期；B组：妈富隆＋FSH-HP组，16例，35个周期。全部患者先用妈富隆治疗2个月并测定治疗前后血清性激素、卵巢体积和窦卵泡数。然后连续促排卵治疗3个周期，停药后比较A组和B组的周期排卵率、妊娠率、

2、卵巢过度刺激综合征（OHSS）发生率和多胎率以及流产率。结果妈富隆治疗后血清LH、FSH、LH/FSH、T、E2、PRL水平，双侧卵巢体积、窦卵泡个数均较治疗前明显下降（P<0.01）。A组和B组周期排卵率分别为81.6%和91.4%、周期妊娠率分别为31.6%和42.9%、周期OHSS发生率分别为7.9%和2.9%、流产率分别为16.7%和13.4%、多胎率分别为16.7%和6.7%，A组和B组各相应的率间比较，差异均无统计学意义（P>0.05）。结论对耐CC的PCOS不孕患者，先行妈富隆前期治疗

3、再用延长CC服药时间或低剂量FSH-HP开始促排卵治疗均能提高卵巢对促排卵的反应性，可以获得较高排卵率、妊娠率和较低OHSS、多胎妊娠的发生率，均是有效的促排卵方案。【关键词】妈富隆;氯米芬抵抗;多囊卵巢综合征ClinicalobservationontheeffectofmawelononinfertilityinwomenwithClomiphene-resistantpolycysticovarysyndrome.SUNJing,QIGuo-hua,XIONGXiao-ying,etal.（S

4、hekouPeople’sHospitalofShenzhen,Shenzhen518067,Guangdong,P.R.China）Abstract：ObjectiveToobservetheclinicaleffectsofmarveloncombinedwithextendedclomiphenecitrate（CC）ormarveloncombinedwithlowdosageFSH-HP（metrodin-HP）oninfertilewomenwithclomiphene-re

5、sistanttopolycysticovarysyndrome（PCOS）.MethodsThere32infertilewomenwithCC-resistanttoPCOSwererandomlydividedintogroupAconsistedof16casesandtreatedwithmarvelonplusCCfor38cyclesGroupBconsistedof16casesandtreatedwithmarvelonplusFSH-HPaldofor35cycles.Befor

6、egivenovulationinductiondrugs,allwomenweretreatedwithmarvelonfor2monthsandthelevelofsexualhormone,ovarysizeandtheovaryantralfolliclecountsbeforeandaftertherapyweredetermined.Ovulationwasinducedafter3inductioncycles,theratesofovulationpercycle,pregnancy

7、percycle,OHSSoccurrencepercycle,multipregnancyandabortionweredeterminedandanalysed.ResultsThelevelsofserumLH,LH/FSH,T,E2,PRL,bilateraloverysizesandantralfolliclecountsweresignificantlyincreased（P<0.01）.Theovulationrates,pregnancyrates,OHSSoccurrencerat

8、espercycle,abortionratesandmultipregnancyratesingroupAandBwere81.6%v.s.91.4%,31.6%v.s.2.9%,7.9%v.s.2.9%,16.7%v.s.13.4%and16.7%v.s.6.7%,respectively,withoutshowingsignificandifferencebewtweengroupAandB（P>0.05）.ConclusionPretreatmentwithm