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目的探讨不同临床处理对体外授精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)中伴溢乳症的不孕症患者妊娠结局的影响。方法选择在邢台不孕不育专科医院生殖中心接受IVF-ET的不孕症患者358例,其中伴溢乳症296例,无溢乳症及基础血清催乳素(prolactin,PRL)正常的62例。按有无溢乳症、高PRL血症及其处理方法分为5组,A组为溢乳症不伴有高PRL血症,应用甲磺酸溴隐亭治疗;B组为溢乳症伴有高PRL血症,应用甲磺酸溴隐亭治疗;C组为溢乳症不伴有高PRL血症,应用中药治疗;D组为溢乳症不伴有高PRL血症,未给予药物治疗;E组为无溢乳症及基础血清PRL正常。比较5组不孕症患者外源性促性腺激素(gonadotropin,Gn)启动日PRL水平、注射绒毛膜促性腺激素(chorionic gonadotrophin,HCG)日PRL水平、获卵数、可用胚胎数、临床妊娠率。结果 5组不孕症患者比较,A组临床妊娠率最低(P<0.05);在Gn启动日和注射HCG日,A组PRL水平低于其他4组(P<0.05)。结论不孕症患者无高PRL血症的溢乳症状无需进行治疗,为改善症状,中药治疗可作为很好的尝试。
Objective To investigate the effect of different clinical treatments on the pregnancy outcome in infertile patients with galactorrhea in IVF-ET (in vitro fertilization and embryo transfer). Methods 358 infertility patients who received IVF-ET in the Reproductive Center of Xingtai Infertility Hospital were enrolled. Among them, 296 cases were accompanied by galactorrhea, 62 cases were free from galactorrhea and normal serum prolactin (PRL). According to the presence or absence of galactorrhea, high PRL hyperlipidemia and its treatment methods are divided into 5 groups, A group of galactorrhea is not associated with high PRL hyperlipidemia, application of bromocriptine mesylate treatment; B group of galactorrhea accompanied by high PRL Serum, application of bromocriptine mesylate treatment; C group of galactorrhea is not associated with high PRL hyperlipidemia, the application of traditional Chinese medicine treatment; D group of galactorrhea is not associated with high PRL hyperlipidemia, no drug treatment; E group No spondylosis and basal serum PRL normal. The PRL levels of gonadotropin (Gn) on the starting day, the PRL level of chorionic gonadotrophin (HCG), the number of oocytes retrieved, the number of embryos available, the clinical pregnancy rate . Results The clinical pregnancy rate was the lowest in group A (P <0.05). In group A, the PRL level in group A was lower than that in the other 4 groups (P <0.05) at the start of Gn and the day of HCG injection. Conclusion Infertility patients with no symptoms of galactorrhea without hyperprolactinemia need to be treated. To improve the symptoms, TCM treatment can be a good attempt.