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目的:了解IVF-ET周期中控制性超促排卵(COH)对阴道微生态的影响。方法:选取2010年4月～2010年10月在北京大学第一医院生殖与遗传中心接受GnRHa-长方案降调节IVF-ET治疗的患者100例,在COH前检查阴道微生态,在HCG注射日再次检查阴道微生态情况,两次结果进行自身对照研究。结果:100例患者中,COH前有微生态失调者13例,其中BV 2例(2%),菌群正常功能下降9例(9%),菌群异常2例(2%)。COH后,菌群失调者42例(42%),其中VVC 9例(9%),BV 6例(6%),BV中间型3例(3%),菌群正常功能下降15例(15%),菌群异常9例(9%),有统计学差异(P<0.05)。87例COH前检查阴道微生态正常者中,COH后34例发生微生态失调(39.9%)。13例COH前检查阴道微生态失调者中,COH后8例发生微生态失调(61.5%),有统计学差异(P<0.05)。结论:接受COH治疗的患者容易发生阴道微生态失调,COH前已经有阴道微生态异常的患者更容易发生微生态失调,建议在进行COH治疗前和取卵手术前进行阴道微生态检查,对BV和VVC患者取卵前采取药物治疗,阴道菌群异常和功能下降患者要密切观察。
OBJECTIVE: To understand the effect of controlled ovarian hyperstimulation (COH) on vaginal microflora in IVF-ET cycles. Methods: From April 2010 to October 2010 in Peking University First Hospital Reproductive and Genetic Center of GnRHa-long program to reduce the regulation of IVF-ET treatment of 100 patients, check the vaginal micro-ecology before COH, on the HCG injection day Again check the vaginal microflora, two results of self-control study. Results: Of the 100 patients, there were 13 cases of dysbiosis before COH, including 2 cases of BV (2%), 9 cases of normal function (9%) and 2 cases of abnormal flora (2%). After COH, 42 cases (42%) were swallowing, including 9 cases (9%) of VVC, 6 cases of BV (6%) and 3 cases of BV intermediate type %), 9 cases of abnormal flora (9%), with statistical difference (P <0.05). Of the 87 patients with normal vaginal microflora examined before COH, 34 had a microecological disorder (39.9%) after COH. Among the 13 cases of pre-COH vaginal microecosystem disorders, 8 cases had COE dysbiosis (61.5%), with statistical difference (P <0.05). CONCLUSIONS: Patients receiving COH are prone to vaginal microecological disorders. Patients who have had vaginal microecological anomalies before COH are more likely to develop microecological disorders. Vaginal microbiological examination is recommended before COH treatment and before ovulation surgery, and BV And VVC patients taking medicine before ovulation, vaginal flora abnormalities and decreased function should be closely observed.