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目的:探讨低剂量克罗米芬(CC)用于女性促排卵治疗的优势。方法:收集行促排卵治疗的女性188例,随机分为常规量组(CC 50mg/d)和低剂量组(CC 25mg/d),患者于月经周期第5天开始服药,第10天检测血清FSH、LH、E2值,经阴道B超监测卵泡发育和子宫内膜情况。比较两组HCG日Gn使用剂量、Gn使用天数、卵泡大小、排卵数及取消周期数。结果:患者的BMI均较高,属于超重。两组患者的年龄、BMI、基础内分泌(FSH、LH、E2、T)水平比较,差异均无统计学意义(P>0.05)。与基础状态相比,用药5天后低剂量组的FSH升高不明显(P=0.69),常规量组FSH明显升高(P=0.000);两组LH及E2水平较基础状态均明显升高(P=0.000),但两组无明显差异(P>0.05)。用药5天及HCG日时,低剂量组的子宫内膜厚度均明显高于常规量组(P=0.000);用药5天后低剂量组的优势卵泡直径明显大于常规量组(P=0.000),但HCG日两组的成熟卵泡直径无明显差异(P=0.56);HCG日低剂量组Gn使用剂量、使用天数及卵泡数明显少于常规量组(P=0.004;P=0.000);低剂量组无取消周期,常规量组有5个取消周期。结论:低剂量CC的促排卵效果与常规剂量相同,同时降低对子宫内膜厚度的影响及多卵泡发育的风险,副作用低,有重要的临床应用价值。
Objective: To investigate the advantages of low dose clomiphene citrate (CC) for ovulation induction in women. Methods: A total of 188 women with ovulation and ovulation induction were enrolled in this study. They were randomly divided into routine dose (CC 50 mg / d) and low dose (CC 25 mg / d). Patients began medication on the 5th day of the menstrual cycle, FSH, LH, E2 values, vaginal B-monitoring of follicular development and endometrial conditions. The dose of Gn, the days of Gn use, the size of follicles, the number of ovulation and the number of canceling cycles were compared between the two groups. Results: The patients had higher BMI and were overweight. There was no significant difference in age, BMI, basal endocrine (FSH, LH, E2, T) between the two groups (P> 0.05). Compared with the basal state, the FSH of the low-dose group did not increase significantly (P = 0.69) and the FSH of the conventional dose group increased significantly (P = 0.000) 5 days after treatment. The levels of LH and E2 in both groups were significantly higher than those in the basal state (P = 0.000), but there was no significant difference between the two groups (P> 0.05). The thickness of endometrium in the low dose group was significantly higher than that in the conventional dose group (P = 0.000) at 5 days and HCG day. The diameter of the dominant follicle in the low dose group was significantly larger than that of the conventional dose group (P = 0.000) However, there was no significant difference in the diameter of mature follicles between the two groups on HCG day (P = 0.56). The dose of Gn, days of use and the number of follicles in HCG low dose group were significantly less than those in conventional dose group (P = 0.004; P = 0.000) The group has no cancellation period, and the normal quantity group has 5 cancellation periods. CONCLUSION: The ovulation-promoting effect of low-dose CC is the same as that of conventional dosage, and it has the same effect on reducing the thickness of endometrium, the risk of multiple follicles, low side effects and important clinical value.