有排卵型不孕患者种植窗时期与经前期子宫内膜分泌改变不一致现象及临床意义

为了解有排卵型不孕妇女种植窗时期子宫内膜分泌情况及其与月经前期内膜的分泌情况和黄体期孕酮值的关系,对59例不孕妇女进行了种植窗时期(LH+7)子宫内膜活检,采用Noyes法确定子宫内膜时相,并与经前期(LH+12)子宫内膜及排卵后5～9天的血孕酮进行比较。结果表明,30.5％的患者两次内膜检查分泌改变不一致,45.8％的患者有一次以上的分泌延迟,其中33.3％二次内膜均延迟,48.1％第一次内膜延迟,第二次内膜正常;18.5％第一次内膜正常,第二次内膜延迟;只有两次内膜检查均延迟的患者血孕酮值有下降。结果提示,种植窗时期的子宫内膜活检诊断黄体功能不全较黄体晚期取材及血孕酮测定敏感性高、临床意义大。

Inconsistent Phenomenon and Clinical Significance of Endometrial Secretion in the Windows of Implantation and in Premenstrual Period in Infertile Women with Ovulation.

To investigate the relationship between the endometrial secretion in the windows of implantation and the secretion in the premenstrual period and the luteal phase serum progesterone level in the infertile women with ovulation. There were 59 endometrial biopsies in the windows of implantation for infertile women. According to Noyes' we dated the endometrial phase and corn-pared with that in the premenstrual period and the serum progesterone 5 - 9 days after ovulation. The results showed that 30.5% twice endometrial secretion were inconsistent; 45. 8% patients had more than once delayed secretion,among whom 33. 3% had twice delayed secretion,48. 1% the first was delayed while the second was normal, 18. 5% first normal,the second delayed. Our results suggested that endometrial biopsy in the windows of implantation was more sensitive and clinically significant than the biopsy taken in the late luteal phase and serial progesterone measurements to diagnose the luteal phase defect.