不同剂量来曲唑对多囊卵巢综合征不孕症患者诱导排卵的临床观察

Clinical study on the effects of different doses of letrozole on ovulation induction in infertile women with polycystic ovary syndrome

目的比较不同剂量来曲唑诱导排卵的临床效果。方法将121例多囊卵巢综合征(polycystic ovary syndrome,PCOS)不孕妇女分为A组57例,B组64例,分别口服来曲唑2.5 mg、5 mg,共5天。阴道B超监测卵泡和子宫内膜生长,内膜薄时口服戊酸雌二醇。最大卵泡平均直径≥18 mm时肌肉注射绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)10 000 U,观察各种临床指标。结果两组子宫内膜厚度、A型内膜比例、戊酸雌二醇用量比较,差异无统计学意义(P>0.05)。注射HCG日优势卵泡数、排卵数B组多于A组,卵泡生长时间B组短于A组(P<0.05),成熟卵泡数、最大卵泡平均直径、排卵率、卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)发生率、自然流产率两组比较,差异无统计学意义(P>0.05)。妊娠率B组显著高于A组(P<0.05)。结论 5 mg来曲唑更适合多囊卵巢综合征不孕症患者诱导排卵。

Objective To compare the effects of 2. 5 mg and 5 mg letrozole on ovulation induction. Methods Totally 121 infertile women with polycystie ovarian syndrome （PCOS） were divided into two groups. In A group, 57 cases were taken 2. 5 mg letrozole once for 5 - day and other 64 cases were taken 5 mg letrozole once for 5 - day. The follicle diameter and endometrial thickness were monitored by the transvaginal ultrasound. The women took estradiol valerate when the endometrial was thin. When the diameter of the biggest follicle reached 18 mm, 10 000 IU human chorionic gonadotrophin （HCG） was injected to trigger ovulation. Results The thickness of endometrium, the ratio about A type of endometrium and the dosage of estradiol were no significant differences（ P 〉 0. 05 ）. The numbers of dominant follicles and total ovulation follicles in B group were higher than those in A group, associated with significantly fewer days of stimulation （ P 〈0. 05 ）. The number of mature follicles, maximum follicle diameter（MFD） ,the rate of ovulation, OHSS rate and spontaneous abortion rate were no significant differences （P 〉 O. 05 ）. The pregnancy rate was significantly higher in B group （P 〈 0.05 ）. Conchmion It appears that 5 mg is a preferable letrozole dose for ovulation induction in infertile women with PCOS.