来曲唑用于多囊卵巢综合征促排卵疗效观察

Effect of Letrozole on ovulation induction in women with polycystic ovary syndrome

目的：探讨来曲唑用于多囊卵巢综合征引起无排卵性不孕妇女的促排卵效果及其对生殖激素的影响。方法：选择2006年1月1日～2007年1月31日于该院就诊的氯米芬抵抗的PCOS患者41例，随机分为2组，来曲唑组（实验组）在月经周期第3～7天口服来曲唑（LE）2．5mg／d，尿促性素组（对照组）在月经周期第3天开始采用低剂量递增法肌注尿促性素（hMG），超声监测卵泡发育，当最大卵泡平均直径≥18mm时，肌注绒毛膜促性腺激素（hCG）10000IU诱发排卵，于hCG日取肘静脉血测定黄体生成素（LH）、雌二醇（E2）、睾酮（T），并观察排卵率、妊娠率、子宫内膜厚度及生殖激素的变化。结果：来曲唑组的排卵率和周期妊娠率与尿促性素组相似（P〉0．05），来曲唑组单个优势卵泡的发生率明显高于hMG组，其成熟卵泡数显著低于尿促性素组（P〈0．05），来曲唑组在hCG日子宫内膜的厚度与尿促性素组相似，来曲唑组在hCG日血清E2、T水平与尿促性素组无明显差异。结论：来曲唑用于氯米芬抵抗引起的无排卵性不孕妇女具有良好的排卵率和妊娠率，且单卵泡排卵率高于尿促性素。

Objective： To evaluate and compare the effect of treatment with Letrozole vs. hMG on the hormonal and biochemical features of patients with polycystic ovarian syndrome （PCOS） . Methods： Forty - one Chinese women with PCOS participated in this prospective, randomized, open-labeled study between January lth 2006 and January 31th 2007. All subjects were divided into two groups randomly： the experimental group received Letrozole （LE） 2.5 mg/d for 5 days during days 3 - 7 of menstrual cirele, the control group was given hMG progressive increasing from 37. 5 mg/d for ovulation induction therapy on the 5th day of menstrual cirele. The transvaginal sonography was applied to observe growth of follicle and ovulation. Then when the follicular diameter was 〉118 mm in length injected hCG 10 000 IU inducing ovalution. Luteinizing hormone （LH） , estradiol （E2）, testosterone （T） levels were estimated with the blood of elbow vein at the day of HCG injection. Ovulation rate, pregnancy rate, the endometrial thickness and reproductive hormones were observed. Results： Ovulation rate and pregnacy rate were similar in experimental group and control group. The morbidity of single dominant follicle was obvioualy higher in experimenta group than that in control group （ P 〈 0. 05 ）, while the number of mature follicle produced a significant reduction in experimenta group. There was no significant reduction after either group for endometrial thickness, E2 and T levels in serum at the day of HCG injection. Conclusion： Letrozole produces a similar ovulation rate and pregnancy rate with hMG. And the morbidity of single dominant follicle is significantly higher in experimenta group than in control group. Therefore, Letrozole may be proved to be effective in the treatment of PCOS.