目的 通过超声观察药物诱发排卯卵泡发育情况、卵泡大小与妊娠率、妊娠结局的关系,旨在探索促排卵正常成熟卵泡大小范围值及最易妊娠卵泡径线范围值。方法 2005,03~2006.09广东医学院附属医院和湛江市霞山妇幼保健院对因排卵功能障碍所致不孕妇女190例进行药物诱发排卵治疗共476个促排卵周期,采用超声监测排卵,并按卵泡大小分组对照观察其周期妊娠率及妊娠结局。结果 促排卵正常成熟卵泡直径范围为20~30mm,平均直径(25.12±3.26)mm;正常排卵周期共373个,周期排卵率78.36%;妊娠172例,周期妊娠率46.11%;卵泡直径24~28mm组、20~23mm组、29~30mm组的周期妊娠率分别为65.52%、23.28%、20.37%,自然流产率分别为6.02%、40,74%、45.45%,周期妊娠率前组显著高于后两组(P〈0.01);周期自然流产率前组显著低于后两组(P〈0.01)。结论 超声对促排卵正常成熟卵泡大小范围值及最易妊娠卵泡径线范围值的探索与研究,将有利于指导临床医生及时调整治疗方案及用药剂量,提高促排卵周期妊娠率及妊娠成功率,减少和预防并发症的发生。
Objective To study the relationship between ovarian follicle size induced by drug ovulation facilitation and pregnant rate and pregnant outcome, and to find the mmmon and easy-pregnant follicle size value in the ovary treated with drug ovulation facilitation. Methods 476 ovulation facilitation cyclm from 190 women treated with drug ovulation facilitation because of mal-ovulation in The Affiliated Hospital of Guangdong Medical College and Maternal and Child Health Hospital in Xiashan District (Zhjiang City) from March 2005 to September 2006 were observed with ultrasound. The follicle size was determined and divided into groups, among which the pregnant ra:e and pregnant outcome were mmpared. Results The common follicular diameters were 20-30mm, with the average (25.12 ± 3.26) mm; 373 out of 476 ovulation facilitation cycles belonged to the nom:al ovulation cycles, with an ovulation rate of 75.36% and a pregnant rate of 46.11% in 172 pregnant women. In groups with follicular dian:eter 24-28mm, 20-23mm and 29-30mm, the cycle pregnant rates were 65.52%, 23.28% and 20, 37%, and the spontaneous abortion rates were 6.02 %, 40.74 % and 45.45 %, respectively. The 24- 28mm group had a higher cycle pregnan- cy rate and lower spontaneous abortion rate than did the 20 - 23mm and 29 - 30mm groups( P 〈 0.01 ). Conclusion The common follicular diameters induced with drug ovulation facilitation could be 20-30 mm, with the easy-pregnant follicle dianeters of 24 -28mm, which could supplied a clue for the clinician to adjust treatment prescription and medication dosage, to raise the cycle pregnant rate and pregnant outcome, and to reduce the pregnant complications.