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目的:研究小剂量GnRH拮抗剂应用于宫腔内人工授精对治疗结局和对子宫内膜容受性的影响。方法:将105例接受宫腔内人工授精的患者分为3组,A组35例,接受HMG促排卵;B组37例,接受HMG+GnRH拮抗剂促排卵;C组33例,不进行促排卵。3组患者均于排卵后7天行超声检查。比较各组治疗结局、超声影像的变化及血流参数的变化。结果:B组卵泡提前黄素化的发生率为5.4%,低于A组和C组(P<0.05);B组HMG用量(907.5±208.4)IU,A组HMG用量(750.0±138.8)IU,B组明显高于A组(P<0.01);B组HCG日LH水平为(4.0±4.8)IU/L,A组为(12.2±8.6)IU/L,A组明显高于B组(P<0.01);B组HCG日P水平为(0.9±1.8)ng/ml,A组P水平为(2.7±1.9)ng/ml,A组明显高于B组(P<0.05)。B组子宫内膜血管体积(0.673±0.319)mm3,子宫内膜下血管体积(8.452±4.039)mm3,与A组比较无统计学差异(P>0.05),与C组比较有统计学差异(P<0.05);B组子宫内膜VI:0.301±0.213,FI:19.813±3.991,VFI:0.055±0.033,VI和VFI与A组比较无统计学差异(P>0.05),与C组比较有统计学差异(P<0.05);FI与A组和C组比较均无统计学差异(P>0.05)。B组子宫内膜下VI:0.987±0.458,FI:20.801±4.527,VFI:0.214±0.045,VI和VFI与A组比较无统计学差异(P>0.05),与C组比较有统计学差异(P<0.05);FI与A组和C组比较均无统计学差异(P>0.05)。结论:小剂量GnRH拮抗剂有效减少促排卵过程卵泡提前黄素化的发生率,不影响子宫内膜的厚度和体积,与促排卵周期患者子宫内膜血流参数相似,比自然周期子宫内膜血管丰富,小剂量GnRH拮抗剂对子宫内膜容受性无负面影响。
Objective: To study the effect of low-dose GnRH antagonist in intrauterine insemination on outcome and endometrial receptivity. Methods: 105 patients undergoing intrauterine insemination were divided into 3 groups: 35 patients in group A received ovulation induction with HMG; 37 patients in group B received ovulation induction with HMG + GnRH antagonist; 33 patients in group C did not undergo promotion ovulation. Three groups of patients underwent ultrasound examination 7 days after ovulation. Compare the treatment outcome of each group, changes in ultrasound imaging and changes in blood flow parameters. Results: The incidence of luteinizing follicles in group B was 5.4%, lower than that in group A and C (P <0.05). The dosage of HMG in group B was (907.5 ± 208.4) IU, the dosage of HMG in group A was (750.0 ± 138.8) IU, (4.0 ± 4.8) IU / L in group B, (12.2 ± 8.6) IU / L in group A, and significantly higher in group A than in group B (P < 0.01). The P level of HCG on day B was (0.9 ± 1.8) ng / ml in group B and (2.7 ± 1.9) ng / ml in group A, P was significantly higher in group A than that in group B (P <0.05). The volume of endometrial blood vessels in group B (0.673 ± 0.319) mm3 and the volume of endometrial blood vessels (8.452 ± 4.039) mm3 in group B were not significantly different from those in group A (P> 0.05) P <0.05). There was no significant difference in V VI and VFI between group A and B (P> 0.05) (P <0.05). There was no significant difference between FI and A and C groups (P> 0.05). There were no significant differences in VI and VFI between group B and group A (P> 0.05), but there was no significant difference between group B and group C (P> 0.05) P <0.05). There was no significant difference between FI and A and C groups (P> 0.05). Conclusion: The low-dose GnRH antagonist effectively reduces the incidence of pre-luteinizing follicles during ovulation induction, does not affect the thickness and volume of endometrium, is similar to endometrial blood flow parameters in patients with ovulation-promoting cycles and is more abundant than natural endometrial blood vessels , Low-dose GnRH antagonists have no negative effects on endometrial receptivity.