单纯来曲唑促排卵在冻融胚胎移植内膜准备中的临床疗效

Clinical effect of letrozole on the ovulation induction in endometrial preparation for frozen-thawed embryo transfer

目的:评价单纯来曲唑(letrozole,LE)促排卵在冻融胚胎移植(frozen-thawed embryo transfer,FET)内膜准备中的临床效果。方法:采用病例对照研究将2010年10月至2011年6月行FET、符合纳入标准的253个周期分为3组,分别采取不同内膜准备方案,包括排卵障碍或月经不规律患者行单纯LE促排卵周期内膜准备85个周期、激素替代治疗(hormone replacement therapy,HRT)84个周期和排卵正常的患者行自然周期内膜准备84个周期;观察各组患者基本情况及生殖相关临床参数的差异。结果:临床妊娠率LE周期组明显高于HRT周期组(54.10%vs44.04%;P<0.05),而LE周期组与自然周期组比较差异无统计学意义(P>0.05);HCG日雌二醇(E2)值LE周期组[(279.70±127.80)pg/mL]明显低于自然周期组[(341.19±113.14)pg/mL](P<0.05);成熟卵泡数、移植日内膜厚度、卵泡生长天数在LE周期组与自然周期组之间差异无统计学意义(P>0.05)。结论:FET内膜准备方案中LE促排卵周期优于HRT周期,与自然周期临床经过及结局相似;LE促排卵内膜准备是排卵障碍或月经不规律患者FET内膜准备的有效候选方案。

Objective： To evaluate the clinical effect of letrozole（LE） alone on the ovulation induction in endometrial preparation for frozen-thawed embryo transfer（FET）.Methods： Totally 253 FET cycles were analyzed by case control study from October 2010 to June 2011.We divided ovulation disorders or menstrual disorders divided into 2 groups： a LE group on ovulation induction cycle（n=85）,and a hormone replacement therapy（HRT） cycle group（n=84）.Meanwhile those who ovulated normally were included in a natural cycle group（n=84）.Demographics and clinical parameters of reproductive correlation of all patients were observed among these groups.Results： The average clinical pregnancy rate of the LE group was higher than that of HRT cycle group（54.1% vs 44.04%;P0.05）.The difference in the parameters such as patients＇ demographics and other clinical indexs had no statistical significance（P0.05）.The estradiol level on human chorionic gonadotrophin（HCG） administration day in the natural cycle group [（341.19±113.14） pg/mL] was higher than that of the LE group [（279.70±127.80） pg/mL]（P0.05）.There was no significant difference in the number of maturation follicles and endometrial thickness on the HCG administration day between the LE group and the natural cycle group（P0.05）.Conclusion： Ovulation induction with LE alone for endometrial preparation is superior to HRT cycle in FET and has similar clinical process and outcome to those of the natural cycle.It can be applied in endometrial preparation for FET effectively for those with anovulation or menstrual disorder.