多囊卵巢综合征患者促排卵周期中成熟卵泡性激素浓度对妊娠的影响

doi:10.3969/j.issn.1006-7795.2020.04.006

摘要/Abstract

摘要： 目的探讨多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者促排卵周期中成熟卵泡性激素六项与妊娠的关系。方法选取2019年3月至2020年1月就诊于首都医科大学附属北京妇产医院内分泌科确诊为PCOS的不孕患者，愿意接受促排卵治疗，自愿签署知情同意书参加本研究项目的妇女共198例（共计470个监测排卵周期）为研究对象。根据患者经过促排卵治疗后是否妊娠分为妊娠组和未妊娠组，比较两组患者年龄、体质量指数（body mass index，BMI）、腰围、臀围、基础内分泌、糖脂代谢、肝肾功能指标及促排卵周期中成熟卵泡出现时的子宫内膜厚度、分型、成熟卵泡大小及性激素六项的差异。结果妊娠组患者促排卵周期中成熟卵泡出现时的E2及T浓度明显高于未妊娠组，妊娠组患者的不孕年限明显短于未妊娠组，成熟卵泡出现的天数晚于未妊娠组患者，妊娠组成熟卵泡出现时的子宫内膜厚度及卵泡大小均大于未妊娠组，差异有统计学意义（P<0.05）；妊娠组和未妊娠组患者的年龄、BMI、腰围、臀围、基础内分泌、糖脂代谢及肝肾功能指标、监测排卵的周期数、子宫内膜分型、成熟卵泡的FSH、LH、PRL、P浓度比较差异无统计学意义（P>0.05）。多因素分析结果表明成熟卵泡的血清E2（1 pg·mL^-1）与妊娠关联强度OR=1.003（95% CI：1.001~1.006）。结论 PCOS患者促排卵周期中成熟卵泡的雌激素浓度的升高对妊娠有积极作用，可在一定程度上对促排卵治疗的成功妊娠起到指导作用。

关键词: 多囊卵巢综合征, 促排卵, 性激素六项, 临床妊娠率

Abstract: Objective To investigate the relationship between six sex hormones of mature follicle in ovulation induction cycle and pregnancy in patients with polycystic ovary syndrome(PCOS). Methods Totally 198 patients (470 cycles of ovulation induction) with PCOS, who were willing to receive ovulation induction treatment for pregnancy in the Beijing Obstetrics and Gynecology Hospital, Capital Medical University from March 2019 to January 2020, signed voluntarily informed consent to participate in this research project. According to whether the patients are pregnant after ovulation induction treatment, they are divided into pregnant and non-pregnant groups. The age, body mass index (BMI), waist circumference, hip circumference, basic glycolipid metabolism, liver and kidney function indexes, endometrial thickness, type, mature follicle size, and sex hormones of the two groups were compared. The sex hormones included follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E2), progesterone(P), prolactin (PRL)and testosterone (T). Results The E2 and T of mature follicles in the period of ovulation induction in the pregnant group were higher than those in the non-pregnant group. The years of infertility in the pregnant group was significantly shorter than that in the non-pregnant group, the days of mature follicles was more than that in the non-pregnant group, and the endometrial thickness and the size of mature follicles in the pregnant group were significantly higher than those in the non-pregnant group (P<0.05). There was no significant difference in age, BMI, waist circumference, hip circumference, glycolipid metabolism, liver and kidney function index, number of ovulation monitoring cycles, endometrial typing, FSH, LH, PRL, and P between pregnant and non-pregnant women (P>0.05). The results of multivariate analysis showed correlation between E2 (pg·mL^-1) and pregnancy with OR=1.003 (95% CI:1.001-1.006). Conclusions The elevation of E2 levels in mature follicles during ovulation induction cycle in patients with PCOS has positive effects on the likelihood of getting pregnant, which could play a guiding role in the successful pregnancy of ovulation induction treatment.

Key words: polycystic ovary syndrome, ovulation induction, six sex hormones, clinical pregnancy rate

中图分类号:

R711.59

秦爽, 阮祥燕, 王宾红, 鞠蕊, 张露平, 豆竹丽, 程姣姣, 金婧. 多囊卵巢综合征患者促排卵周期中成熟卵泡性激素浓度对妊娠的影响[J]. 首都医科大学学报, 2020, 41(4): 530-535.

Qin Shuang, Ruan Xiangyan, Wang Binhong, Ju Rui, Zhang Luping, Dou Zhuli, Cheng Jiaojiao, Jin Jing. The effect of mature follicle sex hormones on pregnancy in the period of ovulation induction in patients with polycystic ovary syndrome[J]. Journal of Capital Medical University, 2020, 41(4): 530-535.

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