来曲唑降低取卵后黄体期雌激素水平及OHSS的发生率

Application of letrozole in decrease of estrogen level and the incidence of OHSS during luteal phase after oocyte retrieval

目的:研究卵巢过度刺激综合征(OHSS)高危患者取卵后使用来曲唑对黄体期性激素的影响及对OHSS的预防作用。方法:193例患者196个OHSS高危体外受精(IVF)/卵胞浆单精子注射(ICSl)周期取卵后行全部胚胎冷冻,并于取卵后根据是否添加来曲唑分为实验组和对照组,实验组取卵后口服来曲唑,对照组不予来曲唑。比较两组患者HCG日(d0)、d2、d4、d9的LH、E2、P水平及中、重度OHSS发生率。结果:实验组和对照组d0和d2的LH、E2、P以及d4LH和P、d9LH和P差异均无统计学意义(P>0.05),实验组d4 E2、d9E2和中、重度OHSS率低于对照组(P<0.01)。结论:OHSS高危患者取卵后添加来曲唑显著降低黄体期E2水平,有效降低中、重度OHSS发生率。

To study the effect of letrozole on sexual hormones during luteal phase among the high risk patients of ovari-an hyperstimulation syndrome （OHSS） after oocyte retrieval and its preventive effect on OHSS. Methods： A total of 196 in vitro fertilization （IVF） /intracytoplasmic sperm injection （ICSI） cycles （193 high risk patients of OHSS） were prepared for embryo cryopreservation after oocyte retrieval, then they were divided into experiment group and control according to adding letrozole or not after oocyte retrieval, the patients in experiment group were treated with oral administration of letrozole after oocyte retrieval, while the patients in control were not treated with letrozole. The levels of luteinizing hormone （ LH）, estradiol, and progestogen, the incidences of moderate and severe OHSS on the day of human chorionic gonadotropin （HCG） injection, the second, the fourth, and the ninth days after HCG injection in the two groups were compared. Results： There was no significant difference in the levels of LH, estradiol, and progestogen on the second day after HCG injec- tion, the levels of LH and progestogen on the fourth day and the ninth day after HCG injection between the two groups （ P 〉 0. 05） . The levels of estradiol, the incidences of moderate and severe OHSS on the fourth day and the ninth day after HCG injection in experiment group were significantly lower than those in control group （P 〈0. 01 ） . Conclusion： Providing letrozole for the high risk patients of OHSS after oocyte retrieval can reduce the level of estradiol during luteal phase and the incidences of moderate and severe OHSS effectively.