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目的观察氯米芬对多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者诱导排卵6个周期的临床疗效。方法 2015年1月至2016年1月四川省妇幼保健院生殖医学中心对收治的186例PCOS患者口服氯米芬50~150 mg诱导排卵,阴道B超监测卵泡和子宫内膜生长。最大卵泡平均直径≥18 mm时,肌注人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)10 000 IU。如未孕则进行第2个周期诱导排卵,最多6个周期。观察相关临床指标。结果氯米芬用量、使用补佳乐患者比例、排卵时处于的月经周期时间随着周期的增加而增加(P<0.05)。注射HCG日子宫内膜厚度及A型内膜比例、成熟卵泡数、最大卵泡平均直径、排卵数各周期比较差异无统计学意义(P>0.05)。第1~6个周期妊娠率分别为:26.79%、18.54%、11.54%、8.70%、7.14%、3.85%,妊娠率随周期增加下降。累积妊娠率逐渐上升,6个周期累积妊娠率为56.40%。结论氯米芬诱导PCOS患者排卵,周期妊娠率逐渐下降,周期数控制在4个周期为宜。
Objective To observe the clinical efficacy of clomiphene for inducing ovulation in 6 patients with polycystic ovary syndrome (PCOS). METHODS: From January 2015 to January 2016, 186 patients with PCOS admitted to Sichuan Reproductive and Medical Center for MCHR were ovariectomized with 50 ~ 150 mg of clomiphene and vaginal B-ultrasound to monitor the growth of follicles and endometrium. The maximum follicle mean diameter ≥ 18 mm, intramuscular injection of human chorionic gonadotrophin (HCG) 10 000 IU. If not pregnant, the second cycle induced ovulation, up to 6 cycles. Observe the relevant clinical indicators. Results The dosage of clomiphene, the proportion of patients with nociceptin, the menstrual cycle time in ovulation increased with the increase of cycle (P <0.05). There was no significant difference in the endometrial thickness and type A intima-media thickness, the number of mature follicles, the average diameter of the largest follicles, and the number of ovulation on the day of HCG injection (P> 0.05). The pregnancy rates of the first cycle to the sixth cycle were 26.79%, 18.54%, 11.54%, 8.70%, 7.14% and 3.85%, respectively. The pregnancy rate decreased with the increase of the cycle. The cumulative pregnancy rate gradually increased, 6 cycles cumulative pregnancy rate was 56.40%. Conclusion Clomiphene induced ovulation in PCOS patients, the rate of pregnancy decreased gradually, and the number of cycles was appropriate in 4 cycles.