Abstract:

Objective　To explore the effect of estradiol valerate tablets combined with metformin for infertility patients. Methods　Eighty-six infertility patients treated at Ankang Central Hospital from July 2021 to September 2022 were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 43 cases in each group. The control group were (29.34±1.81) years old; their body mass index was (27.09±1.63) kg/m²; their disease course was (1.62±0.84) years. The study group were (28.71±1.67) years old; their body mass index was (28.11±1.72) kg/m²; their disease course was (1.58±0.92) years. The control group took valerate estradiol tablets; in addition, the study group orally took metformin. Both groups were treated for 8 weeks. The hormone levels [estradiol (E₂), luteinizing hormone (LH), and serum progesterone (SP)], levels of oxidative stress indicators [advanced oxidation protein products (AOPP) and glutathione peroxidase (GSH-Px)], endometrial thicknesses, and follicle diameters before and after the treatment, ovulation rates, and pregnancy outcomes after 1-year follow-up were compared between the two groups. t test was used for the measurement data, and χ² test for the count data. Results　The hormone levels, oxidative stress indicators, endometrial thickness, and follicle diameter were better after than before the treatment in both groups. After the treatment, the levels of E₂, SP, GSH-Px, LH, and AOPP, endometrial thickness, and follicle diameter in the study group were better than those in the control group [(92.17±8.79) ng/L vs. (79.98±7.67) ng/L, (19.37±2.76) μg/L vs. (14.95±1.94) μg/L, (182.23±18.75) mg/L vs. (169.87±14.98) mg/L, (9.89±1.41) IU/L vs. (11.86±1.38) IU/L, (36.32±3.67) mg/L vs. (51.89±3.32) mg/L, (11.87±1.86) mm vs. (9.82±1.63) mm, and (11.09±1.06) mm vs. (9.87±1.01) mm], with statistical differences (t=6.852, 8.591, 3.377, 6.548, 20.631, 5.435, and 5.464; all P<0.05). There was no statistical difference in the early pregnancy miscarriage rate between the study group and the control group [2.33% (1/43) vs. 6.98% (3/43); χ²=1.049; P=0.306)]. The ovulation rate and pregnancy rate in the study group were higher than those in the control group [86.05% (37/43) vs. 60.47% (26/43) and 67.74% (29/43) vs. 44.19% (19/43)], with statistical differences (χ²=7.182 and 4.715; both P<0.05). Conclusion　Valerate estradiol tablets combined with metformin for infertility patients can improve their endometrial thickness, follicle diameter, hormonal balance, oxidative stress, and ovulation and pregnancy rates.

Key words:

Infertility, Estradiol valerate tablets, Metformin, Endometrial thickness, Hormone levels

摘要：

目的　探讨戊酸雌二醇片联合二甲双胍治疗不孕症患者的效果。方法　选取2021年7月至2022年9月于安康市中心医就诊的86例不孕症患者进行随机对照试验，采用随机数字表法将其分为对照组和研究组，各43例。对照组年龄（29.34±1.81）岁，体质量指数（27.09±1.63）kg/m²，病程（1.62±0.84）年；研究组年龄（28.71±1.67）岁，体质量指数（28.11±1.72）kg/m²，病程（1.58±0.92）年。对照组给予戊酸雌二醇片，研究组在对照组基础上口服二甲双胍治疗，两组持续治疗均8周。比较两组治疗前后激素［雌二醇（E₂）、黄体生成素（LH）、血清孕酮（SP）］和氧化应激指标［晚期氧化蛋白产物（AOPP）、谷胱甘肽过氧化物酶（GSH-Px）］水平、子宫内膜厚度、卵泡直径、排卵率以及经随访1年后妊娠结局。计量资料采用t检验，计数资料采用χ²检验。结果　两组治疗后激素水平、氧化应激指标水平、子宫内膜厚度以及卵泡直径相较于治疗前均有改善。治疗后，研究组患者E₂、SP、GSH-Px水平均高于对照组［（92.17±8.79）ng/L比（79.98±7.67）ng/L、（19.37±2.76）μg/L比（14.95±1.94）μg/L、（182.23±18.75）mg/L比（169.87±14.98）mg/L；t=6.852、8.591、3.377，均P<0.05］，而LH、AOPP水平则低于对照组［（9.89±1.41）IU/L比（11.86±1.38）IU/L、（36.32±3.67）mg/L比（51.89±3.32）mg/L；t=6.548、20.631，均P<0.05］。治疗后，研究组子宫内膜厚度以及卵泡直径均大于对照组［（11.87±1.86）mm比（9.82±1.63）mm、（11.09±1.06）mm比（9.87±1.01）mm；t=5.435、5.464，均P<0.05）］；研究组治疗后早孕流产率与对照组相比，差异无统计学意义［2.33%（1/43）比6.98%（3/43）；χ²=1.049，P=0.306］。研究组排卵率、妊娠率均高于对照组［86.05%（37/43）比60.47%（26/43）、67.74%（29/43）比44.19%（19/43）］，差异均有统计学意义（χ²=7.182、4.715，均P<0.05）。结论　戊酸雌二醇片与二甲双胍联用可增加不孕症患者的子宫内膜厚度和卵泡直径，改善激素平衡和氧化应激，从而提高排卵和妊娠率。

关键词:

不孕症, 戊酸雌二醇片, 二甲双胍, 子宫内膜厚度, 激素水平