【摘要】：目的探討不孕癥婦女自然周期卵泡發(fā)育過程中,過早內(nèi)源性黃體生成素(LH)峰與排卵障礙的相關(guān)性,為不孕癥婦女行自然周期的輔助生殖技術(shù)(ART)治療提供依據(jù)。方法選擇2010年1月—2012年1月衢州市婦幼保健院生殖中心不孕癥門診確診的102例不孕癥患者為研究對象,通過尿LH半定量檢測試紙結(jié)合陰道超聲,檢測出102例不孕癥婦女共244個自然周期的卵泡生長、內(nèi)源性LH峰值及落峰時間、排卵情況,依據(jù)檢測結(jié)果分為尿LH峰陽性組、尿LH峰陰性組及過早LH峰組,比較3組的排卵率、未破裂黃素化卵泡(LUF)發(fā)生率、周期妊娠率。結(jié)果尿LH峰陽性組138個,尿LH峰陰性組44個,過早LH峰組62個。244個自然周期總排卵率為77.0%(188個周期),LUF發(fā)生率為21.3%(52個周期),周期妊娠率為20.9%(51個周期妊娠)。尿LH峰陽性組、尿LH峰陰性組及過早LH峰組的排卵率分別為91.3%、63.6%、54.8%,LUF發(fā)生率分別為8.7%、31.8%、41.9%,周期妊娠率分別為29.0%、11.4%、9.7%;其中尿LH峰陽性組的排卵率、周期妊娠率均高于尿LH峰陰性組和過早LH峰組(P0.05),尿LH峰陽性組LUF發(fā)生率低于尿LH峰陰性組和過早LH峰組(P0.05),尿LH峰陰性組和過早LH峰組的排卵率、周期妊娠率、LUF發(fā)生率比較,差異均無統(tǒng)計學意義(P0.05)。結(jié)論自然周期卵泡發(fā)育過程中容易出現(xiàn)過早的內(nèi)源性LH峰,是導致排卵障礙影響妊娠率的重要因素。臨床實踐中過早內(nèi)源性LH峰的出現(xiàn),可預測提早排卵及黃素化卵泡不破裂綜合征(LUFS)的發(fā)生,可適時注射人絨毛膜促性腺激素,加強黃體支持,以降低LUFS的發(fā)生,提高臨床妊娠率。
[Abstract]:Objective to investigate the correlation between premature endogenous luteinizing hormone (LH) peak and ovulation disorder in infertile women during natural cycle follicle development, and to provide evidence for (ART) therapy of natural cycle assisted reproduction in infertile women. Methods from January 2010 to January 2012, 102 infertile patients diagnosed in the reproductive center of Quzhou Maternal and Child Health Hospital were selected as the study objects. Urine LH semi-quantitative test paper combined with vaginal ultrasound was used. The follicle growth, endogenous LH peak value, peak time and ovulation were detected in 102 infertile women. According to the results, they were divided into three groups: urine LH peak positive group, urine LH peak negative group and premature LH peak group. The ovulation rates of the three groups were compared. The incidence of (LUF) and pregnancy rate of unruptured luteinized follicles. Results there were 138 positive LH peaks in urine, 44 negative LH peaks and 62 premature LH peaks. The total ovulation rate of 244 natural cycles was 77.0% (21.3%) for 188 cycles (52 cycles). The rate of periodic pregnancy was 20.9% (51 cycles). The ovulation rate of urine LH peak positive group, urine LH peak negative group and premature LH peak group were 91.3% and 63.6%, 54.8% respectively. 11. 4 and 9. 7; The ovulation rate and pregnancy rate of urine LH peak positive group were higher than those of urine LH peak negative group and premature LH peak group (P0.05). The incidence of LUF in urine LH peak positive group was lower than that in urine LH peak negative group and premature LH peak group (P0.05). There was no significant difference in ovulation rate, cycle pregnancy rate and LUF incidence between urine LH peak negative group and premature LH peak group (P0.05). Conclusion premature endogenous LH peak is easy to occur in the development of natural cycle follicles, which is an important factor that causes ovulation disorder to affect pregnancy rate. The appearance of premature endogenous LH peak in clinical practice can predict the occurrence of early ovulation and luteinized follicular unruptured syndrome (LUFS), and can inject human chorionic gonadotropin (HCG), strengthen luteal support, and reduce the incidence of LUFS. To increase the clinical pregnancy rate.
【作者單位】： 浙江省衢州市婦幼保健院生殖中心;
【基金】：衢州市科技局項目基金(20091092)
【分類號】：R714.8

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