Shen Huan, Tian Li, Liu Bin
Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2003 Apr 18;35(2):166-9.
To investigate the clinical significance and therapeutic efficacy of small follicular ovulation (SFO) in infertile women and recurrent spontaneous abortion patients.
The clinic features of 103 infertile women and recurrent spontaneous abortion patients with SFO detected by transvaginal B-ultrasonography were retrospectively analyzed. Luteal support alone in natural cycles and ovulation induction were used for treatment, and the pregnant outcomes were compared.
Among the 103 cases there were 74 infertile patients and 49 recurrent spontaneous abortion patients, of whom 20 had both complaints meanwhile. In the 74 infertile patients 31 were diagnosed as LPD (59.5%) and 30 as unexplained infertility (40.5%). The incidence of LPD was 58.1% (18/31) in the recurrent spontaneous abortion patients. The pregnant rate of both nature and induced ovulation cycles were 10.9% (5/46) and 31.0% (9/29) (P = 0.037) respectively in infertile patients, live birth rates were 2.2% (1/46) and 27.6% (8/29) respectively (P = 0.002), spontaneous abortion rates 80.0% (4/5) and 11.1% (1/9) respectively (P = 0.023). The pregnant rate was 28.6% (14/49) in the group of the diameter of follicle > or = 18 mm on HCG injection day, higher than that in the < 18 mm group (6.6%, 4/62) (P = 0.003). Spontaneous abortion rates were 14.3% (2/14) and 75.0% (3/4) respectively, P = 0.019.
SFO may be the cause of infertility and spontaneous abortion. Because only about half patients were diagnosed as LPD, B-ultrasonography is the main method for diagnosis of SFO and we strongly suggest that B-ultrasonography should be a routine examination for unexplained infertility and recurrent spontaneous abortion patients. Pregnant rate is lower and spontaneous abortion rate is higher in the patient with SFO. Induced ovulation treatment can increase the pregnant rate and improve the pregnant outcome.
探讨小卵泡排卵（SFO）在不孕妇女及复发性自然流产患者中的临床意义及治疗效果。
回顾性分析经阴道B超检测出的103例存在小卵泡排卵的不孕妇女及复发性自然流产患者的临床特征。治疗采用自然周期单纯黄体支持及促排卵，比较妊娠结局。
103例患者中，不孕患者74例，复发性自然流产患者49例，其中20例同时存在两种情况。74例不孕患者中，31例诊断为黄体功能不全（LPD，59.5%），30例为不明原因不孕（40.5%）。复发性自然流产患者中LPD发生率为58.1%（18/31）。不孕患者自然周期及促排卵周期的妊娠率分别为10.9%（5/46）和31.0%（9/29）（P = 0.037），活产率分别为2.2%（1/46）和27.6%（8/29）（P = 0.002），自然流产率分别为80.0%（4/5）和11.1%（1/9）（P = 0.023）。HCG注射日卵泡直径≥18 mm组的妊娠率为28.6%（14/49），高于卵泡直径<18 mm组（6.6%，4/62）（P = 0.003）。自然流产率分别为14.3%（2/14）和75.0%（3/4），P = 0.019。
小卵泡排卵可能是不孕及自然流产的原因。由于仅约半数患者诊断为黄体功能不全，B超是诊断小卵泡排卵的主要方法，强烈建议对不明原因不孕及复发性自然流产患者将B超作为常规检查。小卵泡排卵患者妊娠率低、自然流产率高。促排卵治疗可提高妊娠率，改善妊娠结局。
