多囊卵巢综合征患者冻融胚胎移植周期炔雌醇环丙孕酮片预处理后联合来曲唑在内膜准备中的临床效果

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摘要目的探讨多囊卵巢综合征（PCOS）患者冻融胚胎移植（FET）周期进行炔雌醇环丙孕酮片（以下称为“达英-35”）预处理后联合来曲唑在内膜准备中的效果。方法选取2015年3月—2018年7月佛山市妇幼保健院收治的184 例行FET 的PCOS 患者作为研究对象，按照其内膜准备方案的不同将其分为A 组（93 例）和B 组（91 例）。两组患者均给予达英-35 进行预处理，A 组预处理后联合来曲唑准备内膜，B 组采用达英-35 进行预处理后联合激素替代准备内膜，观察两组患者胚胎移植结果、移植成功率、临床妊娠率等情况。结果两组子宫内膜准备天数相较，差异无统计学意义（P＞0.05）；A 组子宫内膜厚度大于B 组，周期取消率低于B 组，差异有统计学意义（P＜0.05）；A 组临床妊娠率高于B 组，差异有统计学意义（P＜0.05）；A 组妊娠后早期流产率低于B 组，差异有统计学意义（P＜0.05）；两组异位妊娠率比较，差异无统计学意义（P＞0.05）。两组妊娠患者子宫内膜厚度、雌二醇水平高于未妊娠者，差异有统计学意义（P＜0.05）；未妊娠患者组间各项指标比较，差异无统计学意义（P＞0.05）。结论达英-35 预处理联合来曲唑对PCOS 患者FET 具有显著效果，可降低患者雄激素水平，提升临床妊娠率。

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关键词 ：多囊卵巢综合征, 冻融胚胎移植, 炔雌醇环丙孕酮片, 联合, 来曲唑, 内膜准备, 临床结果

Abstract：Objective To investigate the effect of Ethinyl Estradiol and Cyproterone Tablets (hereinafter referred to as"Diane-35") pretreatment combined with Letrozole in endometrial preparation of frozen-thawed embryo transfer (FET)cycles in patients with polycystic ovary syndrome (PCOS). Methods A total of 184 patients with PCOS who underwent FET from March 2015 to July 2018 in Foshan Women and Child Hospital were selected as the research objects, and they were divided into group A (93 cases) and group B (91 cases) according to the different endometrial preparation schemes. Both groups were given Diane-35 pretreatment, group A was pretreated with Letrozole to prepare the inner membrane, group B was treated with Diane-35 for pretreatment and hormone replacement to prepare the inner membrane. The results of embryo transfer, the success rate of embryo transfer and the clinical pregnancy rate of the two groups were compared. Results There was no significant difference in endometrial preparation days between the two groups (P＞0.05); the endometrial thickness of group A was greater than that of group B, and the cycle cancellation rate of group A was lower than that of group B, with statistical significances (P＜0.05). The clinical pregnancy rate of group A was higher than that of group B, and the difference was statistically significant (P＜0.05). The early abortion rate after pregnancy in group A was lower than that in group B,and the difference was statistically significant (P＜0.05).There was no statistical difference in ectopic pregnancy rate between the two groups (P＞0.05). The endometrial thickness and estradiol level in pregnant women were higher than those in non-pregnant women, and the differences were statistically significant (P＜0.05). There were no significant differences in the indexes between the non-pregnant groups. Conclusion Diane-35 pretreatment combined with Letrozole has a significant effect on the FET in patients with PCOS, which can reduce the level of androgen in patients and increase the clinical pregnancy rate.

Key words： Polycystic ovary syndrome;Frozen-thawed embryo transfer;Ethinyl Estradiol and Cyproterone Tablets;Combination Letrozole Endometrial preparation Clinical results

收稿日期: 2020-12-18

作者简介: 柳倩茹（1979-），女，广东阳江人，硕士，副主任医师，研究方向：辅助生殖技术临床及内分泌

引用本文:

柳倩茹；陈孟循；黄绮云. 多囊卵巢综合征患者冻融胚胎移植周期炔雌醇环丙孕酮片预处理后联合来曲唑在内膜准备中的临床效果[J]. 中国当代医药, 2021, 28(19): 20-24.
LIU Qian-ru CHEN Meng-xun HUANG Qi-yun. Clinical effect of pretreatment of Ethinyl Estradiol and Cyproterone Tablets in polycystic ovary syndrome patients with frozen-thawed embryo transfer cycles combined with Letrozole in intimal preparation. 中国当代医药, 2021, 28(19): 20-24.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I19/20

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