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目的:探讨经阴道超声引导小卵泡穿刺术对多囊卵巢综合征(PCOS)患者基础内分泌、窦卵泡数目以及妊娠结局的影响。方法:将对克罗米芬(CC)或促性腺激素(Gn)促排无反应,或发生过卵巢过度刺激综合征(OHSS)的PCOS不孕患者100例,随机分为实验组和对照组,每组50例。实验组在尿促性腺激素(HMG)促排卵的同时于月经分泌期行超声引导下小卵泡穿刺;对照组只进行HMG促排卵,连续处理3个月。观察两组基础内分泌和窦卵泡数目的改变,比较两组的妊娠率。结果:与治疗前相比,实验组治疗1、2、3个月后平均黄体生成素(LH)/基础血卵泡刺激素(FSH)、雌二醇(E2)和睾酮(T)水平明显下降,差异有统计学意义(P<0.05),FSH水平较治疗前有所增加,但差异无统计学意义(P>0.05);平均卵巢体积和窦卵泡数目均明显减少(P<0.05),OHSS发生率明显降低,累计妊娠率显著提高,而对照组前后对比变化不显著(P>0.05)。卵泡穿刺后,实验组生殖激素FSH与对照组比较,差异无统计学意义(P>0.05),LH、T、E2水平及LH/FSH、平均卵巢体积和窦卵泡数相比,差异有统计学意义(P<0.05)。结论:经阴道超声引导下小卵泡穿刺治疗能改善PCOS患者生殖基础的紊乱状态,治疗排卵障碍,并增加自然怀孕的几率。
Objective: To investigate the effect of transvaginal ultrasound-guided small follicle aspiration on the basis of endocrine, antral follicles and pregnancy outcomes in patients with polycystic ovary syndrome (PCOS). Methods: One hundred cases of PCOS infertility who did not respond to clomiphene citrate (CC) or gonadotropin (Gn) or had ovarian hyperstimulation syndrome (OHSS) were randomly divided into experimental group and control group. Group of 50 cases. In the experimental group, urinary follicles were punctured with ultrasound guided urinary gonadotropin (HMG) and ovulation induction during the secretory phase of menstruation. The control group only received HMG ovulation for 3 months. The changes of basal endocrine and antral follicles in both groups were observed, and the pregnancy rates of the two groups were compared. Results: The mean LH / FSH, E2 and T levels in experimental group were significantly lower than those before treatment , The difference was statistically significant (P <0.05). FSH levels increased compared with those before treatment, but the difference was not statistically significant (P> 0.05); the average ovarian volume and the number of antral follicles were significantly decreased (P <0.05) The incidence was significantly lower, the cumulative pregnancy rate was significantly increased, while the control group before and after the change was not significant (P> 0.05). After follicular puncture, the experimental group reproductive hormone FSH compared with the control group, the difference was not statistically significant (P> 0.05), LH, T, E2 levels and LH / FSH, the average ovarian volume and the number of antral follicles, the difference was statistically significant Significance (P <0.05). Conclusion: Transvaginal ultrasonography-guided treatment of small follicles can improve the reproductive disorders of PCOS patients, cure ovulation disorders and increase the chance of natural pregnancy.