来曲唑二种剂量促排卵的临床观察

Clinical study on the effects of two doses of Letrozole on ovulation induction

目的比较芳香化酶抑制剂-来曲唑(letrozole,LE)2种不同剂量的促排卵的临床疗效。方法将68例Ⅱ型生殖内分泌异常的不育妇女随机分为2组,其中2.5 mg组33例,5.0 mg组35例,2.5 mg组口服LE 2.5 nag,5.0 mg组口服LE 5.0 mg,均每天1次,连续服用5 d。2组均于月经周期的10 d开始作阴道B超监测,隔天1次最大卵泡平均直径(MFD)<10 mm,肌注人绝经促性腺激素(HMG)75 IU,每天1次,连续3 d后如无优势卵泡出现,则肌注HMG 150 IU,每天1次,至优势卵泡MFD≥18 mm时,肌注人绒毛膜促腺激素(HCG)10 000 IU。结果HCG日≥15 mm卵泡个数,5.0 mg组多于2.5 mg组,卵泡成熟所需天数5.0 mg组少于2.5 mg组,2组比较,差异均有统计学意义(P<0.01);单用LE优势卵泡出现率、三线征阳性率、HCG日子宫内膜平均厚度、HCG日最大卵泡MFD,2组比较,差异均无统计学意义;2.5 mg组临床妊娠率为15.2%(5/33),5.0 mg组为17.1%(6/35);2组均未出现卵巢过度刺激综合征及卵泡未破黄素综合征。结论来曲唑用于Ⅱ型生殖内分泌异常的促排卵治疗时,可以先使用2.5 mg方案,反应不良时可改用5.0 mg。

Objective To compare the clinical effect of two doses of - letrozole （LE） on ovulation induction. Methods Sixty - eight infertiled women with type Ⅱ abnormal reproductive endocrine were randomly divided into two groups, 33 women were in the 2. 5 mg group and 35 women in the 5.0 mg group. The women in two groups took 2. 5 mg or 5.0 mg letrozole once a day for 5 days. Beginning in the 10＇h day after the menstrual period both groups received the vaginal ultrasonic examination once per two days. If the biggest follicle MFD 〈 10 mm, the women received human menopausal gonadotropin 75 IU once a day for 3 days. If there still wasn＇ t any dominant follicle, the women, recieved HMG150Iu once a day untill the dominant follicle MFD ≥ 18 mm. , Then the women was given human chorlonic gonadotropin （HCG） 10000 IU via intramuscular injection. Results 5.0 mg group had more follicles with ≥ 15 mm than 2. 5 mg group in the HCG days, while the days for follicle maturity in 5.0 mg group was significantly less than in 2. 5 mg group （P 〈0. 01 ） ; No significant difference was found between two groups in LE dominant follicle apprearance rate, the positive rate of endmetrial development, average thickness of endometrium in the HCG days. The pregnancy rate was 15.2% for 2. 5mg group, 17. 1% for 5.0 mg group. Both groups didn＇ t have ovary overstimulation syndrome and luteinizing unruptured follicle syndrome. Conclusion For the treatment of type Ⅱ abnormal reproductive endocrine with letrozole, It may be appropriate to use the 2. 5mg scheme first and then use 5. 0mg scheme if, it is not effective,.