摘要
目的分析不明原因不孕患者宫腔内人工授精(IUI)中发生未破裂卵泡黄素化综合征(LUFs)的临床特点,比较LUF周期与正常排卵周期在不同时间各项激素水平及在不同IUI周期LUFs发生情况,探讨LUFs的发病机制。方法对不明原因不孕患者行HMG促排卵IUI治疗140例,228周期为病例组,根据患者是否有排卵分为:未排卵出现LUFs组(A组),正常排卵组(B组),选择因男性因素不孕就诊行自然周期IUI有正常排卵的患者151例对照组(C组),分别在月经周期的第3天、排卵日、LUF日进行性激素测定,对A、B、C组患者不同时间的血清性激素进行比较。对第一周期未孕的不明原因不孕的患者中的88例行第二周期IUI,比较在不同IUI周期时LUF发生情况。结果在排卵日A、B组的FSH、LH和P低于C组(P<0.05)。在LUF日测定的A、B组LH和E2值高于C组(P<0.05)。140例不明原因不孕患者第一周期IUI,29例发生LUFs,发生率为20.71%,对第一周期未孕的不明原因不孕的患者中的88例行第二周期IUI,重复出现LUFs的患者20例,为71.43%。结论围排卵期激素变化可能导致LUFs,促排卵周期LUFs的发生可能与LH峰值偏低或不出现LH/FSH峰有关。在不明原因不孕患者用促排卵IUI周期中LUFs的发生率较高,其发生率可达20.71%,重复治疗周期中LUFs的再次发生率可达71.43%。因此探讨有效方法预防和治疗LUFs在不明原因不孕症治疗尤其是促排卵治疗中有着非常重要的意义。
Objective ： This research analyzes the factors related with luteinized unruptured follicle syndrome （LUFs） of patients with unexplained infertility undergoing intrauterine insemination （IUI）. Methods： A total of 140 women with unexplained infertility who underwent 228 cycles of IU1 and 151 from patients with normal ovulation in male indications were enrolled in the study. The infertile women were treated by IUI. According to the occurrence of LUFs, there were two groups ： Group A, LUFs after induced ovulation, and group B, ovulation after induced ovulation. Besides, normal ovulation in natural cycle as group C, and received the same detection. The levels of the serum FSH, LH, E2 , P were measured respectively on the third day, folhcle maturity day, 48 hours after urine LH ~ or injection with HCG. Ovulation was surveyed with transvaginal uhrasonography （TVS） at the same time. A total of 88 women who failed to conceive in the first cycle underwent second cycles. Results ： 1. The level of FSH, LH and P on follicle maturity day of group A and B obviously was lower than that of group C （P 〈 O. 05）. 2. The level of LH and E2 of group A and B was obviously higher than that of group C on LUF day （P 〈0.05）. 3. Of the total 140 patients who underwent first cycle, 29 （20.71%） had LUF. The in- cidence of LUF was 71.43% in 88 patients who underwent a second cycle of IUI treatment. Conclusion ： During the period of ovulation the hormone changes may play important roles in LUFs. The occurrence of LUFs was associated with low LH level after ovulation induction. The incidence and recurrence rate of LUFs are significantly increased in subsequent cycles of IUI.
出处
《中国优生与遗传杂志》
2013年第3期111-113,共3页
Chinese Journal of Birth Health & Heredity
基金
深圳市科技计划项目(201102094
201202073)
广东省社会发展领域科技计划项目
