PCOS. CC + Gn + Effect of clomiphene citrate and Dingkun Dan on ovulation induction and clinical pregnancy of polycystic ovary syndrome

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1 Vol. 42No. 20 October2017 PCOS 1 2 1* CC+ Gn CC PCOS PCOS 60 A CC + Gn + HCG B CC + Gn + Gn LUFS OHSS A B Gn B P < LUFS OHSS CC PCOS CC + Gn + DOI: /j.cnki.cjcmm Effect of clomiphene citrate and Dingkun Dan on ovulation induction and clinical pregnancy of polycystic ovary syndrome CHEN Lan 1 2 TAN Yong 1* CHEN Shu-ping 1 1. Nanjing University of Traditional Chinese MedicineNanjing China 2. Changzhou Hospital Traditional Chinese MedicineChangzhou China AbstractThe evaluation is based on clomiphene citrate CC+ gonadotropin Gn clinical study on CC and Dingkun Dan' s treatment on ovulation induction and clinical pregnancy effect of PCOSand to provide ideas and methods for traditional Chinese medicine assisted reproductive treatment. This study selected 60 PCOS infertility patients treated with ovulation induction in reproductive medicine clinicjiangsu Province Hospital of traditional Chinese medicine during They were randomly divided into two groupsgroup A CC + Gn + HCGand Group B CC + Gn + Dingkun Dan. These results were observed and compared including cycle ovulation ratecycle cancellation ratecycle pregnancy ratecumulative pregnancy rateendometrial thickness duration of Gntotal amount of Gnthe occurring rate of luteinized unruptured follicle syndrome and ovarian hyperstimulation syndrome. Group A had lower cycle ovulation ratecycle pregnancy ratecumulative pregnancy rate and endometrial thicknesscompared with Group B the difference was statistically significantp < HoweverGroup A had higher cycle cancellation rateduration of Gn and total amount of Gncompared with Group B the difference was statistically significantp < In this studyno case of LUFS or OHSS was found in all patients. CC and Dingkun Dan had the effect of promoting ovulation on PCOS infertility patientsand CC + Gn + Dingkun Dan could elevate clinical pregnancy rate. Key wordsdingkun Danpolycystic ovary syndromeclomiphene citrate * xijun1025@ 163. com chenguazhen@ 126. com 4035

2 Vol. 42No. 20 October2017 polycystic ovary syndrome PCOS / 50 ~ 100 mg 1 5 d polycystic ovaries PCO Gn human menopausal gonadotropin HMG insulin resistance IR 1 PCOS H IU / 2-3 H IU / 75 IU 1 PCOS 9 B PCOS 2003 ES ~ 1 U 1 HRE /ASRM PCOS PCOS B CC + Gn + CC Gn A / 3 PCO 12 2 ~ 9 mm / > 10 ml 0. 5 Z g / d 9 B ~ 18 mm PCOS 1 B B BBT 4 Abbott H mg /40 mg d d β-hcg HCG 35 d B PCOS 1. 6 Gn 2 B Gn lute- unruptured follicle syndrome LUFS 3inized 4 ovarian hyperstimulation syndrome 5 OHSS 6 2 ~ 4 10 mm HCG B PCOS SPSS x 珋 ± s 1. 5 A clomiphene citrate CC+ gonadotropin human chorionic gonadotropin H mg / 16 ~ 18 mm HCG H U / β-hcg B 2 B Gn+ HCG LSD P < P < ~ 5 CC 4036

3 2 PCOS 2. 1 B A B Gn B 1 1 Table 1 General comparison / / / A ± ± B ± ± A B A P < LUFS OHSS B A A P < Table 2 Comparison of ovulation promoting effect Gn Gn /mm /U A ± ± ± B ± ± ± A 1 P < P < Table 3 Comparison of clinical efficacy % A B CC Ding N 15 3 CC PCOS CC PCOS Elbohoty A E 16 5 CC PCOS Gn 17 Birch Petersen K HCG 6 CC 5 PCOS PCOS 15% ~ 40% PCOS Gn PCOS CC 7 CC Hassan A 18 body mass index BMI Gn CC PCOS total testosterone TT anti Gn OHSS mullerian hormone AMH Salaheldin AbdelHamid A M CC Gn Xi W 9 AMH 10 B CC + Gn + PCOS CC A CC + Gn + HCG P < AMH mg L % 65% Vaiarelli A 11 AMH HCG B Gn CC A P < CC + / 12 Paulson M 13 CC Foroozanfard F 14 PCOS 12 Gn + PCOS 4037

4 Vol. 42No. 20 October2017 CC + Gn + HCG luteinizing hormone LH testosterone T follicle-stimulating hormone FSH vascular endothelial growth factor VEGF B CC + Gn + A CC + Gn + HCG P < T A10 homeobox protein A10 HOXA10 20 B A 12Legro R SDodson W CKunselman A Ret al. Benefit of delayed fertility therapy with preconception weight loss over immedi PCOS ate therapy in obese women with PCOS J Metab Wang LQi HBaker P Net al. Altered circulating inflammatory cytokines are associated with anovulatory polycystic ovary syndrome PCOSwomen resistant to clomiphene citrate treatment J. Med Sci Monit Su YWu JHe Jet al. High insulin impaired ovarian function in early pregnant mice and the role of autophagy in this process J. Endocr J2017doi /endocrj. EJ Brüggmann DBerges LKlingelhfer Det al. Polycystic ovary syndromeanalysis of the global research architecture using density equalizing mapping J. Reprod Biomed Online2017 doi /j. rbmo The Rotterdam ESHER /ASRM-Sponsored Pcos Work Shop Group. Revised 2003 consensus on diagnostic criteria and long termheal thrisks related to polycystic ovary syndrome J. Fertil Steril Birch Petersen KPedersen N GPedersen A Tet al. Monoovulation in women with polycystic ovary syndromea clinical review on ovulation induction J. Reprod Biomed Online Seckin BPekcan M KBostanc E Iet al. Comparison of pregnancy rates in PCOS patients undergoing clomiphene citrate and IUI treatment with different leading follicular sizes J. Arch Gynecol Obstet Azziz R. Introductiondeterminants of polycystic ovary syndrome J. Fertil Steril Ellakwa H ESanad Z FHamza H Aet al. Predictors of patient responses to ovulation induction with clomiphene citrate in patients with polycystic ovary syndrome experiencing infertility J. Int J Gynaecol Obstet Xi WYang YMao Het al. Circulating anti-mullerian hormone as predictor of ovarian response to clomiphene citrate in women with polycystic ovary syndrome J. J Ovarian Res 2016doi /s Bani Mohammad MMajdi Seghinsara A. Polycystic ovary syndrome PCOS diagnostic criteriaand AMH J. Asian Pac J Cancer Prev Vaiarelli ADrakopoulos PBlockeel Cet al. Limited ability of circulating anti-müllerian hormone to predict dominant follicular recruitment in PCOS women treated with clomiphene citratea comparison of two different assays J. Gynecol Endocrinol. J Clin Endocrinol 13Paulson MSahlin LHirschberg A L. Progesterone receptors and proliferation of the endometrium in obese women with polycystic ovary syndrome-a lifestyle intervention study J. J Clin Endocrinol Metab2016doi /jc Foroozanfard FRafiei HSamimi Met al. The effects of DASH diet on weight lossanti-müllerian hormone and metabolic profiles in women with polycystic ovary syndromea randomized clinical trial J. Clin Endocrinol Oxf 2017doi / cen Ding NChang JJian Qet al. Luteal phase clomiphene citrate for ovulation induction in women with polycystic ovary syndrome a systematic review and Meta-analysis J. Gynecol Endocrinol Elbohoty A EAmer MAbdelmoaz M. Clomiphene citrate before and after withdrawal bleeding for induction of ovulation in women with polycystic ovary syndromerandomized cross-over trial J. J Obstet Gynaecol Res Balen A HMorley L CMisso Met al. The management of anovulatory infertility in women with polycystic ovary syndrome an analysis of the evidence to support the development of global WHO guidance J. Hum Reprod Update Hassan AShehata NWahba A. Cost effectiveness of letrozole

5 PCOS and purified urinary FSH in treating women with clomiphene citrate-resistant polycystic ovarian syndromea randomized controlled trial J. Hum Fertil Camb Salaheldin AbdelHamid A MRateb A M Ismail Madkour W A. Is clomiphene citrate stair-step protocol a good alternative to gonadotrophins in clomiphene-resistant PCO patients prospective study J. J Obstet Gynaecol Res J J J J

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