论文部分内容阅读
目的 探讨宫腔内人工授精 (IUI)的最佳时机以提高妊娠率。对象 40例 5 3个周期男性不孕及不明原因不孕症患者 ,分为三组 :自然周期组 9例 14个周期 ,用克罗米芬 (CC)促排卵组 15例 17个周期 ,CC+HMG+HCG促排卵组 16例 2 2个周期。方法 经阴道 B超监测卵泡发育并测量子宫内膜厚度及超声类型 ,自主卵泡平均直径达1.6 cm以上时开始进行尿 L H测定。结果 (1)自然周期于卵泡平均直径达 1.8cm时在 2 4小时内排卵居多 (71.42 % ) ,CC与 CC+HMG +HCG促排卵周期主卵泡平均直径达 1.8cm时以 2 4～ 48小时内排卵居多 (分别为 6 4.71%、6 8.18% )。排卵前日平均卵泡直径 :自然周期 1.94± 0 .11(cm) ,CC促排卵周期 2 .2 6± 0 .2 6 (cm) ,HMG+HCG促排卵周期 2 .18± 0 .2 1(cm )。 (2 )自然周期多在尿 L H峰出现后 2 4小时内排卵 (85 .71% ) ,CC与 CC+HMG+HCG周期多于尿 L H峰出现后或 HCG注射后 2 4～ 48小时内排卵 ,两组分别为 80 %、 75 %。排卵日子宫内膜厚度达 10 mm以上 ,内膜超声类型为 A、B时妊娠率较高。结论 决定 IUI时机应综合考虑卵泡的大小、子宫内膜厚度、尿 L H峰与促排卵方案等因素 ,自然周期当卵泡直径达 1.8cm以上、子宫内膜厚度 >9mm,在尿 L H峰出现的 2 4小时内为第一次 IUI的最佳时机 ;
Objective To investigate the best timing of intrauterine insemination (IUI) to improve the pregnancy rate. Subjects 40 cases of 5 infertility infertility and infertility in patients with unknown causes were divided into three groups: 9 cycles of spontaneous cycle group, 14 cycles of 15 cycles of clomiphene citrate (Ovulation group), 17 cycles of CC + HMG + HCG ovulation group 16 cases 2 2 cycles. Methods Transvaginal ultrasonography was used to monitor follicular development and measure endometrial thickness and ultrasonography. When the average diameter of autonomic follicles reached 1.6 cm, urinary L H was measured. Results (1) The natural cycle was mostly ovulation in 21.4 hours (71.42%) when the average diameter of the follicles reached 1.8cm. The average diameter of the main follicles in the CC and CC + HMG + HCG ovulation cycles reached 1.8cm and 24-48 hours Ovulation mostly (6 4.71%, 6 8.18%). The average follicle diameter before ovulation was 1.94 ± 0.11 (cm) in natural period, 2.26 ± 0.26 (cm) in ovulation cycle and 2.18 ± 0.21 (cm) in HMG + HCG ). (2) Most of the natural cycles were ovulation within 24 hours after emergence of LH peak (85.71%), more cycles of CC and CC + HMG + HCG than those after emergence of LH or 2-4 hours after HCG injection , Respectively, two groups were 80%, 75%. Ovulation endometrial thickness of 10 mm or more, endometrial ultrasound type A, B when the pregnancy rate higher. Conclusions The timing of IUI should take into account the follicular size, endometrial thickness, urinary LH peak and ovulation induction and other factors. The natural cycle when the follicle diameter reaches more than 1.8cm, the thickness of endometrium> 9mm, 4 hours is the best time for the first IUI;