The Fifth Clinical Medical College of Shanxi Medical University (Shanxi Provincial People's Hospital) Gynaecology and Obstetrics 030012, China.
The Fifth Clinical Medical College of Shanxi Medical University (Shanxi Provincial People's Hospital) Department of Reproductive Medicine 030012, China.
Biomed Res Int. 2022 Apr 12;2022:6027878. doi: 10.1155/2022/6027878. eCollection 2022.
A retrospective cohort study aimed to explore the effects of different ovulation induction regimens on the levels of sex hormones and serum C1q/TNF-related protein-3 (CTRP3) and C1q/TNF-related protein-15 (CTRP15) in patients with PCOS.
A total of 100 patients with PCOS treated in the department of gynecology and obstetrics from February 2019 to April 2021 in our hospital were enrolled. The patients were arbitrarily assigned into control group and study group. The treatment effect, pregnancy rate, ovulation rate, follicle size, thickness of endometrium, number of mature follicles and ovulation, serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), serum CTRP3, CTRP15 and menstrual score were compared.
There exhibited no statistical difference in baseline clinical data between the two kinds of patients. The therapeutic effects were compared, the effective rate was 98.00% in the study group, 13 cases in the control group, 20 cases in the effective group and 7 cases in the control group, and the effective rate was 86.00%. The effective rate in the study group was higher (P <0.05). The size of follicles and the thickness of endometrium in the two groups were compared before and after intervention. There exhibited no significant difference in the size of follicles and the thickness of endometrium before and after intervention (P >0.05). The size of follicles and the thickness of endometrium in the study group were significantly higher (P <0.05). The size of follicles and the thickness of endometrium in the study group were significantly higher (P <0.05). There exhibited no significant difference in the number of mature follicles and ovulation before and after intervention (P >0.05). After intervention, the number of mature follicles and ovulation in the two groups increased. The number of mature follicles and ovulation in the study group were (4.76 ± 0.90) and (4.48 ± 0.73), respectively, which were higher compared to the control group (2.45 ± 0.86) and (2.82 ± 0.84), respectively (P <0.05). The levels of serum LH, FSH, E2 and T were not significantly different before and after intervention. After the intervention of different ways of ovulation induction, the levels of serum LH, FSH, E2 and T in the two groups continued to decrease, and the levels of the above sex hormones in the study group were significantly lower (P <0.05). The menstrual score and the levels of serum CTRP3 and CTRP15 were compared before and after intervention. After intervention, the menstrual score of patients in both groups decreased, and the menstrual score of the study group was lower. In addition, the levels of serum CTRP3 and CTRP15 in the two groups decreased after intervention. Compared with the control group, the levels of CTRP3 and CTRP15 in the study group were lower after intervention (P <0.05). The ovulation rate and pregnancy rate of the two groups were compared. In the study group, there were 45 ovulation cases, the ovulation rate was 90.00% (45/50), the pregnancy rate was 33 cases, the pregnancy rate was 66.00% (33/50), and the ovulation rate in the control group was 31 cases, the ovulation rate was 62.00% (31/50), the pregnancy rate was 20 cases, and the pregnancy rate was 40.00% (20/50). The ovulation rate and pregnancy rate in the study group were higher (P <0.05).
Different ovulation induction regimens have different effects on the levels of sex hormones and serum CTRP3 and CTRP15 in patients with PCOS. Long-acting follicular phase regimens can effectively promote the therapeutic effect of patients and increase the ovulation rate and pregnancy rate. In addition, it can also reduce the levels of serum LH, follicle stimulating FSH, E2 and testosterone T, and help to promote the levels of serum CTRP3 and CTRP15, which is worth popularizing and applying in clinic.
回顾性队列研究旨在探讨不同促排卵方案对多囊卵巢综合征(PCOS)患者血清 C1q/肿瘤坏死因子相关蛋白 3(CTRP3)和 C1q/肿瘤坏死因子相关蛋白 15(CTRP15)水平及性激素的影响。
选取 2019 年 2 月至 2021 年 4 月我院妇产科收治的 100 例 PCOS 患者为研究对象,采用随机数字表法分为对照组和观察组,各 50 例。比较两组患者的治疗效果、妊娠率、排卵率、卵泡大小、子宫内膜厚度、成熟卵泡数及排卵数、血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、睾酮(T)、血清 CTRP3、CTRP15 及月经评分。
两组患者的基线临床资料比较,差异无统计学意义。比较两组患者的治疗效果,观察组有效率为 98.00%(49/50),对照组有效率为 86.00%(43/50),观察组有效率高于对照组,差异有统计学意义(P<0.05)。两组患者干预前后卵泡大小和子宫内膜厚度比较,干预前后两组患者卵泡大小和子宫内膜厚度比较,差异无统计学意义(P>0.05)。观察组患者卵泡大小和子宫内膜厚度明显高于对照组,差异有统计学意义(P<0.05)。两组患者成熟卵泡数及排卵数比较,干预前后两组患者成熟卵泡数及排卵数比较,差异无统计学意义(P>0.05)。干预后两组患者成熟卵泡数及排卵数均增加,观察组患者成熟卵泡数及排卵数分别为(4.76±0.90)个、(4.48±0.73)个,均高于对照组的(2.45±0.86)个、(2.82±0.84)个,差异有统计学意义(P<0.05)。两组患者干预前后血清 LH、FSH、E2、T 水平比较,差异无统计学意义(P>0.05)。不同促排卵方案干预后,两组患者血清 LH、FSH、E2、T 水平继续下降,观察组患者上述性激素水平明显低于对照组,差异有统计学意义(P<0.05)。两组患者干预前后月经评分及血清 CTRP3、CTRP15 水平比较,干预后两组患者月经评分均降低,观察组患者月经评分低于对照组,差异有统计学意义(P<0.05)。此外,两组患者血清 CTRP3、CTRP15 水平均降低,观察组患者血清 CTRP3、CTRP15 水平明显低于对照组,差异有统计学意义(P<0.05)。两组患者排卵率及妊娠率比较,观察组患者排卵率为 90.00%(45/50),妊娠率为 66.00%(33/50);对照组患者排卵率为 62.00%(31/50),妊娠率为 40.00%(20/50)。观察组患者排卵率和妊娠率均高于对照组,差异有统计学意义(P<0.05)。
不同促排卵方案对 PCOS 患者的性激素及血清 CTRP3、CTRP15 水平有不同的影响。长效卵泡期方案能有效提高患者的治疗效果,增加排卵率和妊娠率,同时还能降低血清 LH、FSH、E2、T 水平,有助于促进血清 CTRP3、CTRP15 水平的升高,值得在临床上推广应用。