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目的:探讨不同术前个体条件对B超引导下卵巢间质激光治疗PCOS的疗效有无影响。方法:选择2006年8月～2008年8月间就诊的、对克罗米芬促排卵无反应的PCOS患者60例进行B超引导下经阴道卵巢内激光治疗,根据不孕类型、不孕年限、体重指数、有无闭经、LH水平、LH/FSH比值、T水平、平均卵巢径线及平均小卵泡数等因素分别进行分组,比较上述自身因素对术后6个月内自发排卵率和累积妊娠率的影响。结果:60例患者中,术后6个月内自发排卵率为61.7%(37/60),累积临床妊娠率为53.3%(32/60)。原发不孕和有闭经病史的患者术后自发排卵率较低,但是一旦有排卵,则对妊娠率无影响;BMI和术前LH水平虽然对自发排卵率无影响,但是BMI>25kg/m2和LH≤10U/L的患者妊娠率较低。结论:继发不孕和无闭经病史的患者对B超引导下经阴道卵巢内激光治疗的反应较好,体重指数正常及LH>10U/L的患者则在术后获得较高的妊娠率。
Objective: To investigate the effect of different preoperative individual conditions on the efficacy of ultrasound-guided ovarian mesenchymal laser treatment of PCOS. Methods: From August 2006 to August 2008, 60 PCOS patients who did not respond to clomiphene induced ovulation underwent transvaginal ovarian laser treatment under B-ultrasound. According to the type of infertility, duration of infertility, body weight Index, amenorrhea, LH level, LH / FSH ratio, T level, average ovarian diameter and the average number of small follicles and other factors were grouped to compare the above factors on their own within 6 months after spontaneous ovulation and cumulative pregnancy rate Impact. Results: In 60 patients, the rate of spontaneous ovulation was 61.7% (37/60) within 6 months and the cumulative clinical pregnancy rate was 53.3% (32/60). The incidence of spontaneous ovulation was lower in patients with primary infertility and history of amenorrhea, but once ovulation, there was no effect on pregnancy rate. Although BMI and preoperative LH levels had no effect on spontaneous ovulation rate, BMI> 25kg / m2 And LH ≤ 10U / L patients with lower pregnancy rates. CONCLUSIONS: Patients with secondary infertility and no history of amenorrhea responded well to B-guided transvaginal intra-ovarian laser treatment. Patients with normal body mass index and LH> 10 U / L achieved higher postoperative pregnancy rates.