Abstract:

Objective　To explore the clinical effects of different medication methods on ovulation in patients with polycystic ovary syndrome (PCOS). Methods　A retrospective analysis was made on 124 PCOS patients [333 COH (controlled ovarian hyperstimulation) cycles in total] who received COH treatment in The First Affiliated Hospital of Jiangxi Medical College from June 2019 to December 2021. The patients' age ranged from 26 to 39 years old, with an average of 30.6 years old. The duration of infertility ranged from 3 to 8 years, with an average of 4.6 years. The patients were divided into a study group and a control group according to different medication methods. The 61 cases (162 cycles) in the study group received divided medication, and the 63 cases (171 cycles) in the control group received one-time medication. Both groups were treated with metformin hydrochloride sustained-release tablets, troglitazone, letrozole, follicle-stimulating hormone (FSH), urinary gonadotropin (HMG), and human chorionic gonadotropin (HCG). The average dose per cycle, the number of mature follicles, the clinical pregnancy rate, and the incidence of ovarian hyperstimulation syndrome (OHSS) were compared between the two groups. χ² test or Fisher exact probability method were used. Results　The average dose per cycle was 17.5 pills and the clinical pregnancy rate was 42.6% (26/61) in the study group, which were higher than 14.4 pills and 25.4%(16/63) in the control group; the average number of mature follicles obtained per cycle was 2.11 and the incidence of OHSS was 3.3% (2/61), which were lower than 3.43 and 15.9% (10/63) in the control group; there were statistically significant differences (all P<0.05). Conclusion　The divided medication method can improve the clinical pregnancy rate and reduce the incidence of OHSS in the ovulation induction for PCOS patients.

Key words:

Polycystic ovarian syndrome, Controlled ovarian hyperstimulation, Ovarian hyperstimulation syndrome, Rotterdam criteria

摘要：

目的　探讨不同给药方法对多囊卵巢综合征（PCOS）患者排卵治疗的临床效果。方法　回顾性分析2019年6月至2021年12月在江西医学高等专科学校第一附属医院接受控制性促排卵（COH）治疗的PCOS患者124例（共333个COH周期），患者年龄26～39岁、平均年龄30.6岁，不育时间3～8年、平均不育时间4.6年。将患者根据不同给药方法分为研究组和对照组，其中分次给药组为研究组，共61例，162个周期；1次给药组为对照组，共63例，171个周期。两组患者均采用盐酸二甲双胍缓释片、曲格列酮、来曲唑、促卵泡激素（FSH）、尿促性腺激素（HMG）和人绒毛膜促性腺激素（HCG）多种药物联合治疗方案。比较两组治疗方案的平均周期用药量、成熟卵泡数、临床妊娠率及卵巢过度刺激综合征（OHSS）发生率。采用χ²检验或Fisher确切概率法。结果　研究组的平均周期用药量17.5支、临床妊娠率42.6%（26/61），高于对照组的14.4支平均周期用药量及25.4%（16/63）的临床妊娠率，而平均每个周期获得的成熟卵泡数2.11个及OHSS发生率3.3%（2/61），低于对照组的3.43个及15.9%（10/63），差异均有统计学意义（均P<0.05）。结论　分次给药在PCOS患者诱发排卵治疗中可提高临床妊娠率，并降低OHSS发生率。

关键词:

多囊卵巢综合征, 控制性促排卵, 卵巢过度刺激综合征, 鹿特丹共识