对确诊为多囊卵巢综合征 (PCOS) 的不育患者的评估和治疗策略

Jafrin Yasmin Choudhury, Dr. Nahid Elora, Dr. Habiba Akther, Dr. Jakia Jahan Chowdhury, Dr. Umme Sayeeda Bilkish, Dr. Mustofa Khalid Ahmed Jaigyrder
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摘要

背景:多囊卵巢综合征是女性最常见的内分泌疾病,可导致与慢性无排卵和雄激素过多有关的各种疾病,也是导致女性不孕的常见原因。它是育龄妇女中最常见的内分泌和代谢疾病。多囊卵巢综合征(PCOS)是导致无排卵性不孕的最常见原因,占所有病例的 75% 以上。这个普遍存在的问题影响着大约六分之一的婚姻,其原因在不同国家和社会群体中各不相同。目的和目标:本研究旨在评估确诊为多囊卵巢综合征(PCOS)的不孕患者的治疗策略。材料与方法:本研究调查了 80 例由多囊卵巢综合征引起的不孕症患者。从 2021 年 8 月到 2022 年 7 月,本研究对一所三级医学院的 80 例多囊卵巢综合征不孕症患者进行了评估。诊断采用激素测定、超声波和腹腔镜检查。治疗方案包括枸橼酸克罗米芬、来曲唑和腹腔镜卵巢钻孔术。研究结果在我们的研究中,大多数患者(50%)的年龄在 26 至 30 岁之间,100% 的患者主诉不孕,其中 66.25% 属于原发性不孕。73.75%的女性出现月经异常。约 85% 的应答者 LH 与 FSH 的比值大于 1.6,77.5% 的女性患有多囊卵巢增大。枸橼酸克罗米芬的受孕率为 24%,来曲唑 31% 的受孕率为 20%,而腹腔镜卵巢钻孔术后再使用来曲唑的受孕率为 60%。结论多囊卵巢综合征是一种复杂的疾病,需要根据患者寻求治疗的原因采用不同的治疗技术。除了改善饮食和增强体质外,大多数受孕率较高的患者都需要进行生活方式调整治疗,如C/C和腹腔镜卵巢钻孔术。
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Evaluation and Treatment Strategies for Infertile Patients with Diagnosed Polycystic Ovary Syndrome (PCOS)
Background: PCOS is the most common endocrine disorder in women that can lead to a variety of ailments associated with chronic anovulation and hyperandrogenism, it is also still a common cause of infertility in women. It is the most frequent endocrine and metabolic disorder among reproductive-aged women. PCOS (polycystic ovarian syndrome) is the most frequent cause of anovulatory infertility, accounting for more than 75% of all cases. This widespread problem affects around one in every six marriages and has a variety of causes across countries and social groups. Aims and Objective: The objective of this study was to evaluate the treatment strategies for infertile patients with diagnosed Polycystic Ovary Syndrome (PCOS). Material and Methods: This study looked at 80 cases of infertility caused by polycystic ovarian syndrome. From August 2021 to July 2022, this study evaluated 80 cases of infertility with PCOS at a tertiary medical college. The diagnosis was made using a hormone assay, ultrasound, and laparoscopy. Treatment options included clomiphene citrate, letrozole, and laparoscopic ovarian drilling. Results: In our study, the majority (50%) were between the ages of 26 and 30 years old, and 100% of patients complained of infertility, with 66.25% being of the primary type. Menstrual abnormalities affected 73.75% of women. The LH: FSH ratio was greater than 1.6 in approximately 85% of responders, and 77.5% of women had enlarged polycystic ovaries. Clomiphene citrate had a conception rate of 24%, Letrozole 31% had a rate of 20%, and laparoscopic ovarian drilling followed by Letrozole had a rate of 60%. Conclusion: Polycystic ovarian syndrome is a complex illness that necessitates a variety of treatment techniques based on the reason a patient seeks treatment. Aside from diet and fitness improvements, most patients with good conception rates require lifestyle modification treatment such as C/C and laparoscopic ovarian drilling.
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