来曲唑在高龄不孕患者体外受精-胚胎移植中的应用价值被引量：2

Application value of letrozole in in vitro fertilization-embryo transfer of elderly patients with infertility

导出

摘要目的:探讨来曲唑在高龄不孕患者体外受精-胚胎移植中的应用价值。方法:回顾性分析2008年3月～2010年8月接受IVF/ICSI-ET治疗的82例高龄不孕患者(年龄38～45岁),按促排方案分为来曲唑组(超短方案,n=37)与对照组(短方案,n=45)。比较组间的促性腺激素(Gn)使用剂量、Gn用药时间、绒毛膜促性腺激素(HCG)注射日子宫内膜(Em)厚度及血清促黄体生成素(LH)值、雌二醇(E2)值、获卵数、MII卵数、受精率、卵裂率、优质胚胎率、冷冻胚胎率、种植率和妊娠率。结果:来曲唑(LE)组与对照组Gn使用剂量、Gn用药时间、HCG日子宫内膜厚度、获卵数、MII卵数、受精率、妊娠率比较,差异无统计学意义(P>0.05)。来曲唑组HCG日血清激素LH值、E2值明显低于对照组,种植率明显高于对照组,差异有统计学意义(P<0.05)。结论:LE用于高龄不孕妇女超促排卵行IVF/ICSI-ET助孕,可以克服超生理剂量雌激素对内膜的毒性作用,对子宫内膜容受性的影响较小,胚胎种植率明显提高,有助于提高IVF/ICSI-ET妊娠率。 Objective：To explore the application value of letrozole in in vitro fertilization-embryo transfer（IVF-ET） of elderly patients with infertility.Methods：82 elderly patients（aged 38~45 years old） with infertility receiving IVF/intracytoplasmic sperm injection（ICSI）-ET from March 2008 to August 2010 were analyzed retrospectively,then they were divided into letrozole group（ultrashort protocol,n=37） and control group（short protocol,n=45）.The dose,duration time of gonadotropin（Gn）,the thickness of endometrium on the day of human chorionic gonadotropin（HCG） injection,serum luteinizing hormone（LH） levels,estradiol levels,the number of oocytes retrieved,the number of MⅡ oocytes,the fertilization rate,the cleavage rate,the rates of high quality embryos,the rates of frozen embryos,the implantation rates and pregnancy rates in the two groups were compared.Results：There was no significant difference in the dose,duration time of Gn,the thickness of endometrium on the day of HCG injection,the number of oocytes retrieved,the number of MⅡ oocytes,the fertilization rate and pregnancy rate between the two groups（P0.05）.The serum levels of LH and estradiol on the day of HCG injection in letrozole group were significantly lower than those in control group,while the implantation rate was significantly higher than that in control group（P0.05）.Conclusion：Letrozole used in IVF/ ICSI-ET for ovulation induction of elderly patients with infertility can overcome the toxic effect of estrogen of physiological dose on endometrium,which has less impact on the receptivity of endometrium;letrozole can increase the implantation rate obviously and it is helpful to improve the pregnancy rate of IVF/ICSI-ET.

作者孟琳高士友郭玉佳邓朝晖阳翎罗曼唐慧珍柳朝华

机构地区湖南省妇幼保健院生殖医学中心

出处《中国妇幼保健》 CAS 北大核心 2011年第12期1835-1837,共3页 Maternal and Child Health Care of China

关键词来曲唑高龄促排卵体外受精-胚胎移植 Letrozole Elderly Ovulation induction In vitro fertilization-embryo transfer

分类号 R711.6 [医药卫生—妇产科学]

引文网络
相关文献

参考文献8

1GosWami SK, Das T, Chattopadhyay et al. A randomized single - blind controlled trial of letrozole as a low cost IVF protocol in women with poor ovarian response: a preliminary report[J]. Hum Reprod, 2004, 19 (9) : 2031.
2Garcia- Velasco, Moreno L, Pacheco A et al. The aromatase inhibitor letrozole increase the concentration of intraovarian androgens and improves in vitro fertilization outcome in low responder patients: a pilot study [J] . Fertil Steril, 2005, 84 (1): 82.
3May - Panloup P, Chretien MF, Jacques C et al. Low ooeyte mitoehondrial DNA content in ovarian insufficiency [J] . Hum Reprod, 2005, 20 (3) : 593.
4李路,陆湘,林跃,高晓红,吴煜,徐冰,王永卫,孙晓溪.来曲唑联合促卵泡素在PCOS患者IVF-ET中的应用及效价分析[J].生殖与避孕,2009,29(11):722-726. 被引量：5
5Malmusi S, La Marca A, Giulini Set al. Comparison of a gonadotropin - releasing hormone (GnRH) antagonist and GnRH agonist flare - up regimen in poor responders undergoing ovarian stimulation[J].. Fertil Steril, 2005, 84 (2): 402.
6Martin J, A1Fadhli R, Casper RF et al. Congenital malformations among 911 new borns conceived after infertility treatment with letrozole or clomiphene citrate [J] . Fertil Steril, 2006, 85 (6) : 1761.
7Verpost WM, Kolibianakis E, Papanikolaou E et al. Aromatase inhibitors in ovarian stimulation for IVF/ICSI: a pilot study [ J] . Reprod Biomed Online, 2006, 13 (2): 166.
8Weghofer A, Margreiter M, Bassim S et al. Minimal stimulation using recombinant follicle - stimulating hormone and a gonadotropin - releasing hormone antagonist in woman of advanced age [ J] . Fertil Steril, 2004, 81 (4): 1002.

二级参考文献11

1章汉旺,李莉,李清,邓彧,段秀娟.来曲唑和克罗米酚对小鼠着床期子宫内膜容受性的影响[J].生殖与避孕,2007,27(4):251-254. 被引量：27
2Mitwally MF, Casper RF. Use of an aromatase inhitor for induction ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril, 2001,75 (2):305-9.
3MitwaUy MF, Casper RF. Aromatase inhibition reduces the dose of gonadotropin required for controlled ovarian hyperstimulation. J Soc Gynecol Invest, 2004,11(61): 406-15.
4Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod, 2004, 19(1):41-7.
5Healey S, Tan SL, Tulandi T, et al. Effects of letrozole on superovulation with gonadotropins in women undergoing intrauterine insemination. Fertil Steril, 2003, 80 (6):1325-9.
6Mitwally MF, Biljan MM, Casper RF. Pregnancy outcome after the use of an aromatase inhibitor for ovarian stimulation. Am Obstet Gynecol, 2005,192(2):381-6.
7Goswami SK, Das T, Chattopadhyay R, et al. A randomized single--blind controlled trial of letrozole as a low-cost IVF protocol in women with poor ovarian response: a preliminary report. Hum Reprod, 2004,19(9):2031-5.
8Verpoest WM, Kolibianakis E, Papanikolaou E, et al. Aromatase inhibitors in ovarian stimulation for IVF/ ICSI: a pilot study. Reprod Biomed Online, 2006, 13 (2): 166-72.
9Noriega-Portella L, Noriega-Hoces L, Delgado A, et al. Effect of letrozole at 2.5 mg or 5.0 mg/day on ovarian stimulation with gonadotropins in women undergoing intrauterine insemination. Fertil Steril, 2008, 90(5): 1818-25.
10Cortinez A, Carvalho ID, Vantman D, et al. Hormonal profile and endometrial morphology in letrozole-controlled ovarian hypestimulation in ovulatory infertile patients. Fertil Steril, 2005, 83(1):110-5.