During the journey of pregnancy, a mother’s health and nutritional status directly impact the baby’s development. Most expectant mothers focus on supplementing sufficient nutrients like folic acid, calcium, and protein during pregnancy, but iron—an often overlooked element—is actually crucial for the health of both mother and baby. A recent study published in the top international journal Nature showed that iron deficiency in pregnant mice leads to sex reversal of their fetal mice embryos from male to female, resulting in the feminization of male fetuses. No clinical cases regarding the impact of iron deficiency during pregnancy on fetal sex differentiation have been reported, but the effects of iron deficiency during pregnancy on pregnant women and fetuses are relatively clear. This article will reveal the hazards of iron deficiency during pregnancy, especially its long-term health impacts on mothers, babies, and offspring, combined with the latest research, while introducing treatment methods for iron deficiency during pregnancy.

The 16th World Congress on Endometriosis 2025 (WCE 2025) kicked off on May 21, 2025, at Darling Harbour in Sydney, Australia. Lasting for 4 days, the conference concluded successfully on May 24, 2025. It attracted over 1,000 delegates from 43 countries, including top experts in the global endometriosis field who presented the most cutting-edge research findings. The agenda was splendid, featuring lectures and discussions in various modules focusing on endometriosis pathogenesis theories, diagnostic targets, treatment, and related social-mental health issues. Special sessions such as the China-Australia Special Session, India-Australia Special Session, and European Endometriosis League (EEL) Special Session were also set up to promote academic exchanges among scholars from different countries. In addition to inviting experts and scholars to give oral presentations, the conference venue included a poster research gallery and roundtable discussion sessions, integrating diverse academic exchange formats. This push summarizes some wonderful moments of the conference and provides a brief share for readers.

Recently, CRISPR gene-editing technology has achieved significant progress in the field of rare disease treatment. Two patients of different age groups have successfully received treatment, bringing hope to millions of rare disease patients worldwide.

On the night of August 1, 2025, Dr. Shao, an obstetrician and gynecologist at Zhoukou No.6 Hospital in Henan Province, fell from a high floor of the hospital. Her life was forever frozen on that summer night. This sudden tragedy quickly evolved from an accident into a public event that triggered widespread social reflection — as information spread, details emerged that Dr. Shao had endured cyberbullying before her death. Amid waves of shock and sorrow, a heavy question arises: when medical disputes, cyberbullying, and issues related to medical workers' practice environments intersect, are there urgent gaps to be addressed in our legal protection system and social support network?

At 3:30 PM UTC on October 6, 2025, the 2025 Nobel Prize in Physiology or Medicine was officially announced. American scientists Mary E. Brunkow, Fred Ramsdell, and Japanese scientist Shimon Sakaguchi were awarded the prize for their "discoveries concerning peripheral immune tolerance." The prize money amounts to 11 million Swedish kronor (approximately 8.34 million Chinese yuan).

In global infertility cases, male factors account for up to 40%, among which azoospermia and cryptozoospermia account for approximately 10%-15% of male infertility cases. For couples affected by this, years of repeated invasive treatments and lengthy manual sperm searches often end in failure, forcing them to face the choice of donor sperm or adoption. On October 31, 2025, researchers from Columbia University Medical Center published a study titled "First clinical pregnancy following AI-based microfluidic sperm detection and recovery in non-obstructive azoospermia" in the international top medical journal The Lancet. The Sperm Tracking and Recovery (STAR) system developed in this study has brought revolutionary changes, successfully achieving the world's first clinical pregnancy and opening up a new fertility path for patients with severe male factor infertility. The STAR System: Innovative Integration of AI and Microfluidics The STAR system is a fully automated, non-invasive sperm detection and recovery platform. Its core consists of three major components that work together to achieve efficient and accurate sperm identification and separation. Firstly, a high-speed imaging system capable of continuously capturing phase-contrast images at 300 frames per second. Secondly, a custom-designed Fusion DTx microfluidic chip that provides a precise microenvironment for sperm separation. Finally, a deep learning-based object detection model adopting the YOLO architecture, specifically trained and optimized with annotated sperm images. The system's operational efficiency is impressive: it can analyze 400 microliters of semen samples per hour, with an image capture and processing rate of 1.1 million images per hour. To ensure detection accuracy, the research team added a temporal consistency filter—only when a target is identified at least 3 times in approximately 10 consecutive frames is it confirmed as a sperm. Once sperm are identified, a microfluidic gating mechanism separates them into a volume of 300 nanoliters. All fluidic components are disposable, ensuring sterility and eliminating the risk of cross-contamination. The entire system operates in a closed manner to maximize biosafety. In validation experiments, when a known number of sperm (5-100 per 400 microliters) were added to azoospermic samples, the STAR system's detection results showed an extremely high linear correlation with the actual number of added sperm (R²=0.99), with a detection precision of 0.89, recall of 0.90, and mean average precision of 0.95 at an intersection over union of 0.5—fully demonstrating its detection reliability. Breaking the 20-Year Infertility Dilemma: First Successful Clinical Pregnancy The first clinical application of the system was on a couple who had suffered from infertility for 19 years. The 39-year-old male patient underwent a comprehensive reproductive urological evaluation, showing a normal karyotype, no Y-chromosome microdeletions, and normal serum testosterone and follicle-stimulating hormone levels. However, scrotal ultrasound revealed bilateral testicular atrophy with microlithiasis and no signs of varicocele. He had previously undergone multiple large-scale manual sperm searches and two testicular sperm extraction surgeries, recovering only a small number of rare sperm. The 37-year-old female patient had severe diminished ovarian reserve with an anti-Müllerian hormone level of only 0.17 ng/mL. Over the past 11 years, she had undergone 19 oocyte retrieval cycles at 4 reproductive centers, including multiple oocyte cryopreservation due to insufficient sperm. Intracytoplasmic sperm injection (ICSI) attempted in some cycles failed due to low fertilization rates, resulting in only 1 transferable embryo that did not lead to pregnancy. During treatment, the research team gently washed a 3.5-milliliter ejaculated semen sample, resuspended it in 800 microliters of semen analysis buffer, and processed it with the STAR system. No sperm were found in manual smear examinations, but the STAR system analyzed 2.5 million images in approximately 2 hours, successfully detecting 7 sperm—2 motile and 5 non-motile. Doctors injected the motile sperm into 2 mature oocytes (1 freshly retrieved and 1 thawed), both of which developed into cleavage-stage embryos; the other 2 thawed oocytes injected with non-motile sperm did not continue to develop. On day 3, the two embryos were successfully transferred. Thirteen days after transfer, the patient obtained the first positive pregnancy result, which was ultimately confirmed as a clinical pregnancy. At 8 weeks of gestation, ultrasound examination showed normal fetal development with a heart rate of 172 beats per minute, and the patient has been transferred to obstetric care. Technological Innovation: Rewriting the Treatment Landscape for Severe Male Infertility Traditional sperm recovery methods for azoospermia and cryptozoospermia often rely on invasive surgery or long-term manual searches by embryologists, which are not only time-consuming and labor-intensive with low success rates but also highly influenced by the operator's experience. In contrast, the STAR system combines real-time AI technology with precise microfluidic technology to achieve non-invasive, automated identification and recovery of rare sperm, completely changing this situation. Although the STAR system has previously successfully recovered and cryopreserved sperm in other azoospermic patients, this case marks the first time that recovered sperm have been directly used for fertilization leading to clinical pregnancy, and it is also the world's first clinical pregnancy achieved through sperm identified and recovered by an AI-guided microfluidic platform. Despite being based on a single case, this breakthrough fully demonstrates the feasibility of the technology and brings new hope to patients with severe male factor infertility who have long faced treatment difficulties. Currently, larger-scale clinical studies are underway to evaluate the reproducibility, effectiveness, and treatment outcomes of the technology in a broader patient population. The successful application of the STAR system highlights the transformative potential of AI-guided microfluidic technology in reproductive medicine, which is expected to further expand the boundaries of fertility care and restore fertility hope to more infertile patients once deemed "untreatable."

Recently, the news that "the world's first gestation robot is expected to be launched within a year with a price tag of no more than 100,000 yuan" has gone viral and sparked heated discussions. Zhang Qifeng, founder of a robot company in Shenzhen, stated that this "robot mother" can house a "gestation chamber" simulating the uterine environment, replicating the human experience from pregnancy to childbirth, and may even address the issue of population decline. While this claim sounds highly sci-fi, a review of the actual global progress in artificial womb research suggests things may not be that straightforward. The Global March of Artificial Womb Research Despite a series of achievements in artificial womb research worldwide, numerous tough technical challenges remain to realize full-term human fetal gestation by robots. In terms of simulating the internal environment, the human uterus is extremely complex and sophisticated. Hormone secretion and regulation, precise nutrient supply, and stable maintenance of the immune environment are all key hurdles for artificial wombs to overcome. For instance, during different stages of pregnancy, maternal hormone levels undergo dynamic changes to meet the fetus’s developmental needs—estrogen, progesterone, and other hormones fluctuate within strict ranges and timelines. Accurately replicating this hormonal regulation mechanism in an artificial womb is far more difficult than imagined. Regarding nutrient supply, there is currently no mature solution to ensure artificial wombs can provide comprehensive, balanced, and appropriately timed nutrients like the human body does. At the external device level, the blood circulation system of existing artificial wombs also has shortcomings. Relevant research from the First Affiliated Hospital of Zhengzhou University points out that current blood circulation systems for artificial wombs lack efficiency and stability in critical processes such as oxygen supply to the fetus, nutrient delivery, and waste excretion. Additionally, ensuring the sterility of artificial "amniotic fluid" during regular replacements is challenging. Once contaminated, it can easily cause fetal infections, posing a serious threat to fetal health. Ethical Dilemmas: A Crossroads of Choices Beyond technical obstacles, the development of artificial womb technology faces complex and severe ethical challenges. From the perspective of parent-child relationships, in traditional reproduction, mothers and fetuses form deep emotional bonds over ten months of gestation. This natural emotional connection rooted in life-giving is a cornerstone of parent-child relationships in human society. However, if fetuses are gestated by robots, this way of building emotional bonds will be completely altered. The emotional and legal definitions of parent-child relationships will become ambiguous, and traditional family ethical orders will face unprecedented impacts. From the perspective of social equity, without strict regulation, artificial womb technology may spawn commercial interest chains, leading to inequality in reproductive rights. Wealthier groups may easily access the technology, while ordinary people could be excluded due to financial burdens. This will undoubtedly exacerbate the uneven distribution of social resources and widen the gap between social classes. In terms of legal norms, current global legal systems have numerous gaps in areas related to artificial wombs. For example, how to determine the identity, rights, and obligations of infants born via artificial wombs; what rules should govern the protection and use of genetic information—these are all urgent legal issues that need to be addressed. Rational Perspective: Hope with Caution While the news of the world’s first gestation robot is fascinating, based on the current state of artificial womb technology, there is still a long way to go before it matures and is widely applied. For researchers, while tackling technical challenges, they should actively collaborate with ethicists, legal experts, and other interdisciplinary professionals. They need to thoroughly explore the ethical and legal issues that may arise from technological development, formulate response strategies in advance, and ensure technological progress aligns with the basic values of human society. For the general public, we should view this cutting-edge technology rationally and objectively. We should neither blindly embrace it while ignoring potential risks nor completely reject it, missing the opportunity for technological progress to transform human life. Perhaps in the future, with technological maturity and the improvement of ethical and legal frameworks, artificial wombs can play a significant role in assisted reproduction, preterm infant care, and other fields, contributing to human health and well-being. But for now, in the face of news like the "world’s first gestation robot," we need to exercise more calm thinking and less blind following. Let us collectively look forward to the harmonious coexistence of technology and humanity on this journey of exploration, creating a better tomorrow for all.

On September 11, the State Council Information Office announced that HPV vaccine vaccination services for eligible girls will be launched this year, and the HPV vaccine will be officially included in the National Immunization Program (NIP). This marks the first time that the target population of immunization has been expanded from children under 6 years old to adolescents, and the scope of diseases prevented has been extended from infectious diseases to the field of tumors. The formulation and promotion of this policy allow all people to truly feel its far-reaching significance for public health, and inject strong momentum into China's process of eliminating cervical cancer. To this end, we have specially invited Professor Lihui Wei from Peking University People's Hospital, an expert in the field of cervical cancer prevention and treatment, to share professional insights and practical guidance in combination with this policy and program. Steady Advancement of Prevention and Control Path from Planning to Implementation In January 2023, the National Health Commission, together with 10 ministries and commissions including the Ministry of Education and the Ministry of Finance, issued the Action Plan for Accelerating the Elimination of Cervical Cancer (2023-2030). This plan clearly states that it is necessary to improve the comprehensive prevention and control mechanism of cervical cancer, promote HPV vaccine vaccination for eligible girls, accelerate the review and approval of domestic vaccines that meet the requirements, and encourage regions with conditions to take the lead in pilot projects. In clinical practice, we can see how these plans are transformed into practical actions step by step—from the exploration of local pilots to the current national-level coverage of the immunization program, each step has made the prevention and control network more tight. Behind this initiative lies the adoption and continuation of China's mature ideas and experience in preventing and controlling infectious diseases through vaccines. From the perspective of clinical prevention and treatment practice, the preventive effect of the HPV vaccine on cervical cancer reflects the core value of "shifting the focus forward". Clinical data have long confirmed that 99.7% of cervical cancers are related to HPV infection, and the vaccine can accurately block the infection of high-risk HPV, which is equivalent to setting up a protective barrier before the onset of the disease. The inclusion of the HPV vaccine in the National Immunization Program is precisely to extend this barrier to more people, especially adolescents, providing protection before they are exposed to the risk of the virus. China's Actions Under the Global Goal This year marks the fifth anniversary countdown to the 2030 goal of accelerating the elimination of cervical cancer proposed by the World Health Organization (WHO). China's inclusion of the HPV vaccine in the National Immunization Program is a specific practice in response to this global goal. This initiative not only reflects the country's emphasis on public health—building a herd immunity barrier by increasing vaccination rates—but also takes into account the diversity of individual needs, providing people with more choices. From the perspective of the global prevention and control pattern, the elimination of cervical cancer requires each country to explore paths in light of its own national conditions. China's inclusion of the vaccine in the immunization program is not only in line with the "universal protection" concept advocated by WHO, but also demonstrates China's great power responsibility in the field of public health. Solidifying the Foundation and Meeting Diverse Needs The HPV vaccine included in the National Immunization Program this time accurately meets the core needs of China's cervical cancer prevention and control, which can quickly improve the level of group protection and lay a solid group foundation for the elimination of cervical cancer. It should be specially noted that HPV vaccine vaccination is not limited to the age range covered by the immunization program—women of other age groups who meet the criteria can also choose the vaccine freely according to their own needs. At present, there are domestic and imported HPV vaccines of bivalent, quadrivalent, and nonavalent types on the Chinese market. Different valency types cover different virus subtypes, which can meet diverse protection needs. From the perspective of China's epidemiological characteristics, women have two peak periods of HPV infection, which means that HPV vaccine vaccination for the entire population aged 9-45 is of great practical significance. Whether it is adolescents in the younger age group or adult women with protection needs, timely vaccination can effectively reduce the risk of HPV infection and add protection to their own health, which is also one of the important directions for China to promote cervical cancer prevention and control. In addition, a number of studies have shown that HPV vaccine vaccination for men can not only help achieve the WHO cervical cancer elimination goal faster when vaccine coverage is insufficient and further reduce the HPV infection rate among both men and women, but also prevent diseases such as penile cancer, anal cancer, and genital warts in men themselves, and reduce the risk of transmitting the virus to partners, contributing to the elimination of cervical cancer. At present, the imported nonavalent HPV vaccine has been approved for vaccination in men aged 16-26, providing an option for men's protection. The Responsibility and Mission of Medical Workers Professor Lihui Wei from Peking University People's Hospital stated that as medical workers, promoting the prevention and control of cervical cancer is an unshirkable responsibility. First, actively recommend HPV vaccine vaccination for eligible populations. Focus on recommending vaccination for eligible people aged 9-45, and especially advocate for people in the younger age group to be vaccinated as early as possible—clinical data have confirmed that completing vaccination before exposure to the HPV virus can achieve the optimal protective effect, which is also a key link in reducing the risk of cervical cancer. Second, do a good job in popularizing knowledge about diseases and prevention. Convey core information to the public, such as the relationship between HPV infection and cervical cancer, and the principle of vaccine protection, helping the public establish scientific cognition and reduce misunderstandings. At present, China has issued a number of authoritative expert consensuses and clinical guidelines in the field of cervical cancer prevention and treatment, such as the Chinese Clinical Application Guidelines for Prophylactic Human Papillomavirus Vaccines (2025 Edition) and the Expert Consensus on Cervical Cancer Screening and Abnormal Management in China. These documents provide clear and standardized guidance for clinical practice and popular science work. Medical workers can carry out their work in combination with the content of the guidelines to ensure the scientificity and professionalism of prevention and control measures and better serve public health. A Promising Future: Accelerated Achievement of Prevention and Control Goals With the inclusion of the HPV vaccine in the National Immunization Program, the vaccination rate is expected to increase significantly; combined with the continuous advancement of cervical cancer screening, this "dual-pronged" prevention and control model will surely effectively control cervical cancer, a "killer" threatening women's health. Moreover, medical workers' promotion of work in accordance with guidelines and the expansion of protection dimensions such as male vaccination have brought the goal of eliminating cervical cancer closer. Professor Wei said that as a medical worker who has long been engaged in cervical cancer prevention and treatment, she deeply feels the great responsibility while witnessing this process, and is also full of confidence in the achievement of the goal. In the future, we will continue to do a good job in vaccination guidance and popular science education, so that more people can truly enjoy the health dividends brought by policies and science.

胎盘滞留作为产后常见的严重并发症，一直是困扰产科医生的难题。近日，发表在《American Journal of Obstetrics and Gynecology MFM》上的一项Meta分析揭示了一个重要结论：广泛应用于胎盘滞留治疗的硝酸甘油，在临床效果上并未展现出显著优势。这一发现为产科临床实践提供了关键的循证医学证据，也为重新审视胎盘滞留的治疗策略敲响了警钟。

摘要 多囊卵巢综合征（PCOS）是女性常见的生殖内分泌代谢性疾病，严重影响女性生命质量、生育及远期健康。目前西医以降低雄激素、调整月经周期、改善胰岛素抵抗等对症治疗为主，中医药辨证施治在改善代谢障碍、减轻体重、恢复自然排卵等方面具有特色及优势，《多囊卵巢综合征中西医结合诊疗指南》的建立具有重要的临床实用价值和指导意义。 定义 PCOS是女性常见的生殖内分泌代谢性疾病，临床表现为月经异常、不孕、高雄激素血症、卵巢多囊样表现等，同时可伴有肥胖、胰岛素抵抗、血脂异常等代谢异常，是2型糖尿病、心脑血管疾病和子宫内膜癌发病的高危因素，严重影响患者的生活质量。 PCOS属于中医“闭经”“崩漏”“不孕”等范畴，PCOS并发症包含了中医“肥胖”“消渴”“脂浊”“癥瘕”“粉刺”等疾病的部分内容。 诊断与分型 育龄期及围绝经期PCOS的诊断标准： 推荐意见：依据病史、临床症状及辅助检查结果判断（专家共识度：100%）。 病史：有月经异常病史，可表现为月经稀发、闭经或不规则子宫出血；或有不孕症病史；家族中可有糖尿病、肥胖、高血压病、体毛过多的病史，以及女性亲属的月经异常状况、生育异常状况、妇科肿瘤病史。 临床症状： （1）月经异常：初潮后1~3年月经周期＜21天或＞45天；月经初潮后3年至围绝经期月经周期＜21天或＞35天，或1年内＜8个月经周期；初潮1年后任何＞90天的月经周期；年龄＞15岁的原发性闭经，或者是乳房发育后3年仍无月经来潮者。 （2）高雄激素症状：痤疮、多毛、脂溢性脱发。 辅助检查： （1）血清生殖激素浓度测定：①高雄激素血症；②抗苗勒管激素（AMH）水平较正常明显增高；③20%~35%的PCOS患者可伴有血清催乳素（PRL）水平轻度增高。 （2）盆腔超声检查：多囊卵巢形态（PCOM）至少一侧卵巢内直径为2~9mm的卵泡≥20个； （3）代谢并发症筛查：口服葡萄糖耐量试验（OGTT），胰岛素释放试验；空腹血脂、肝功能检查等； （4）其他内分泌激素：酌情选择甲状腺功能、皮质醇、肾上腺皮质激素释放激素（ACTH）、17-羟孕酮测定等。 疑似PCOS：月经稀发或闭经或不规则子宫出血是诊断的必需条件。另外再符合下列2项中的1项：（1）高雄激素临床表现或高雄激素血症；（2）超声表现为PCOM。 确诊PCOS：具备上述疑似PCOS诊断条件后，还必须逐一排除其他可能引起高雄激素的疾病和引起排卵异常的疾病才能确定PCOS的诊断。 01 青春期PCOS的诊断标准 推荐意见：诊断青春期PCOS的必要条件是月经不规律以及排卵障碍，高雄激素临床表现和/或高雄激素血症。排除其他导致排卵障碍及雄激素过多的疾病。对于青春期女性，PCOM在月经初潮8年内的女性中较为常见，此期不建议根据超声检查出PCOM来诊断PCOS（专家共识度：95.83%）。 鉴别诊断： 1、高雄激素血症或高雄激素症状的鉴别诊断 （1）库欣综合征（CS），又称皮质醇增多症； （2）非经典型先天性肾上腺皮质增生（NCCAH）； （3）卵巢或肾上腺分泌雄激素的肿瘤； （4）其他：药物性高雄激素血症；特发性多毛有阳性家族史，但血清睾酮水平及卵巢超声检查均正常者。 2、排卵障碍的鉴别诊断 （1）功能性下丘脑性闭经； （2）甲状腺疾病； （3）高泌乳素血症； （4）早发性卵巢功能不全。 02 中医辨证分型 推荐意见：本指南包括痰湿内阻证、肾阳亏虚证、肝经郁热证三个常见证型，辨证要点如下： （1）痰湿内阻证（强推荐，专家共识度：91.67%）。主症：月经后期，月经量少，甚则闭经，婚久不孕，带下量多；次症：形体肥胖，疲乏无力，多毛，大便溏泄；舌脉：舌淡胖、苔白腻，脉滑。 （2）肾阳亏虚证（弱推荐，专家共识度：54.17%）。主症：月经后期，月经量少，甚则闭经，婚久不孕，带下量多；次症：形体较胖，头晕耳鸣，小腹冷，性欲衰退，小便清长，大便时溏；舌脉：舌淡或淡胖、苔白，脉沉细弱。 （3）肝经郁热证（弱推荐，专家共识度：54.17%）。主症：月经后期，月经量少，甚则闭经，或崩漏淋漓，婚久不孕，经前乳房胀痛；次症：面部痤疮，形体壮实或肥胖，烦躁易怒，多毛，口苦咽干，两胁闷胀不舒；舌脉：舌红、苔薄黄，脉弦数。 治疗 01 PCOS的中西医结合治疗原则 推荐意见：由于PCOS患者年龄、治疗需求和临床表现异质性大，因此，临床处理应该根据患者主诉、治疗需求、代谢改变采取个体化的对症治疗措施，在调整生活方式的基础上，结合调整月经周期、调整代谢、治疗高雄激素、诱导排卵等。 对于临床症状或体征已得到缓解的患者，仍应关注远期风险，建议开展多学科合作，制定系统的长期管理规划。在此原则上，中医治疗以补肾治其本，健脾理气化痰、疏肝解郁泻火、活血化瘀调经治其标，标本同治。同时还应根据月经周期的不同时间和患者的体质情况辨证论治（专家共识度：100%）。 青春期PCOS的中西医结合治疗原则 推荐意见：治疗时需考虑其年龄、生理特征以及青春期少女的社会心理因素，根据患者的主诉、需求及代谢变化采取规范化和个体化的对症治疗，如调整生活方式、调整月经周期、缓解高雄激素症状、改善多毛及痤疮、降低胰岛素、调整心理状态等治疗，以不影响青春期正常生长发育为原则，需要长期治疗，以调整月经周期并预防子宫内膜病变。中医治疗以补肾治其本，辨证论治，标本同治。但不建议常规促排卵治疗。对于有心理健康障碍的青春期患者，必要时给予专科处理（专家共识度：100%）。 02 PCOS的中西医结合治疗模式 推荐意见：（1）对于没有生育需求的PCOS患者，生活方式干预是其基础治疗，改善临床症状，逐渐恢复规律排卵，预防和管理远期并发症是主要治疗策略。根据患者的临床现，按照中医辨证分型施治，并结合中医周期疗法调整月经周期。若中医疗2个月仍无排卵者，定期给予孕激素为主的性激素治疗或复方口服避孕药，保护子宫内膜，防治远期并发症。对于合并代谢障碍的多囊卵巢综合征患者，在改善生活方式、中医辨证治疗基础上，结合二甲双胍、噻唑烷二酮类（吡格列酮）、奥利司他等药物口服治疗（专家共识度：100%）。 （2）有生育需求的PCOS患者，确认是否存在引起生育失败的危险因素，如肥胖、未控制的糖耐量异常、糖尿病、高血压等。减重、改善代谢障碍是促进生育的基础治疗。中医辨证调经助孕，结合西药促排卵治疗。经以上治疗均无效或合并其他不孕因素（如高龄、输卵管因素或男方因素等）时进行辅助生殖技术支持，如体外受精-胚胎移植术（IVF-ET）等（专家共识度：100%）。 03 治疗方法及药物 针对无生育需求的PCOS患者的中医或中西医结合治疗 推荐意见1：在生活方式干预的基础上，合并月经异常的患者，需根据患者的年龄、内分泌及代谢条件选择短效复方口服避孕药（COC）、周期性用孕激素或雌孕激素序贯治疗。对于青春期和育龄期有高雄激素血症及多毛、痤疮等高雄激素表现的患者选择短效COC。对短效COC治疗效果不佳，有短效COC禁忌或不能耐受短效COC的高雄激素患者选择螺内酯。 合并代谢障碍的患者，根据患者的具体情况，结合使用二甲双胍、噻唑烷二酮类（吡格列酮）、阿卡波糖、他汀类等西药治疗。上述药物使用方法及注意事项可参考《多囊卵巢综合征中国诊疗指南》（专家共识度：100%）。 推荐意见2：在上述治疗基础上，结合中药辨证治疗。 （1）痰湿内阻证治则治法：化痰除湿，通络调经。推荐药物：苍附导痰丸（药物组成：茯苓、法半夏、陈皮、甘草、苍术、香附、胆南星、枳壳、神曲、生姜）联合炔雌醇环丙孕酮/炔雌醇环丙孕酮及二甲双胍（证据级别：C，强推荐）。 （2）肾阳亏虚证治则治法：温肾助阳，调补冲任。推荐药物：右归丸（药物组成：熟地黄、山药、山萸肉、枸杞子、菟丝子、鹿角胶、杜仲、当归、炮附片、肉桂）（证据级别：C，强推荐）。 （3）肝经郁热证治则治法：疏肝理气，泻火调经。推荐药物：丹栀逍遥散（药物组成：牡丹皮、栀子、当归、白芍、北柴胡、白术、茯苓、甘草、生姜、薄荷）联合炔雌醇环丙孕酮（推荐级别：C，强推荐）。若伴见两胁胀痛、头晕目眩、倦怠食少、脐腹胀痛，使用加味逍遥丸（药物组成：北柴胡、当归、白芍、白术、茯苓、甘草、牡丹皮、栀子、薄荷）（推荐级别：Ⅳa，强推荐）。 针对有生育需求的PCOS患者的中医或中西医结合治疗 推荐意见1：在持续性无排卵或稀发排卵的PCOS患者，经生活方式干预及排除其他导致不孕的因素和不宜妊娠的疾病后，根据患者月经周期、内分泌及代谢条件进行诱导排卵。 推荐意见2：促排卵期间，联合中药辨证治疗。 （1）痰湿内阻证治则治法：化痰除湿，通络调经。推荐药物：苍附导痰丸药物组成：茯苓、法半夏、陈皮、甘草、苍术、香附、胆南星、枳壳、神曲、生姜）联合促排药物（证据级别：B，强推荐）；启宫丸（药物组成：半夏曲、苍术、香附、茯苓、神曲、陈皮、川芎）联合促排药物（证据级别：C，强推荐）。 （2）肾阳亏虚证治则治法：温肾助阳，调补冲任。推荐药物：复方玄驹胶囊（药物组成：黑蚂蚁、淫羊藿、枸杞子、蛇床子）联合促排药（证据级别：B，强推荐）。若伴见腰酸疼痛、赤白带下，使用暖宫孕子丸（药物组成：熟地黄、香附、当归、川芎、白芍、阿胶、艾叶、杜仲、续断、黄芩）联合二甲双胍（证据级别：C，强推荐）。 （3）肝经郁热证治则治法：疏肝理气，泻火调经。推荐药物：丹栀逍遥散/丸（药物组成：牡丹皮、栀子、当归、白芍、北柴胡、白术、茯苓、甘草、生姜、薄荷）联合二甲双胍及促排药/炔雌醇环丙孕酮预处理后用促排药/炔雌醇环丙孕酮（推荐级别：C，强推荐）。 04 外治疗法 推荐意见1：可适当选用针刺（证据级别：B，强推荐）、灸法证据级别：C，强推荐）。 （1）针刺方法：选取天枢、气海、关元、中极、子宫（双）、足三里（双）、三阴交（双）等穴。痰湿内阻证配丰隆（双）。 （2）灸法（温针灸）：选取关元、气海等穴。肾阳亏虚证配命门、腰阳关（双）、腰俞（双）。 文章来源：周惠芳,洪艳丽,刁飞扬,等. 多囊卵巢综合征中西医结合诊疗指南（2024年版） [J]. 中医杂志, 2025, 66 (06): 649-656. 责编：煎薯片