来曲唑对多囊卵巢综合征患者促排卵的影响

The effect of letrozole on patients with polycystic ovary syndrome

目的：探讨来曲唑（LE）对多囊卵巢综合征（PCOS）患者促排卵的影响.方法：44周期口服促排卵药后有优势卵泡生长且正常排卵的PCOS患者,根据口服促排卵药不同分为2组.LE组20周期：月经周期或撤退性出血第5天口服LE 5 mg/d共5 d,氯米芬组（CC组）24周期：月经周期或撤退性出血第5天口服CC 100 mg/d,共5 d.比较2组患者的周期临床妊娠率及早孕流产率等.结果：LE组中人绒毛膜促性腺激素日子宫内膜厚度高于CC组,周期临床妊娠率高于CC组,血清雌激素水平低于CC组（P〈0.05~P〈0.01）;LE组人绒毛膜促性腺激素日优势卵泡数、血清促黄体生成素水平、血清孕激素、三线征内膜率和早孕流产率与CC组差异均无统计学意义（P〉0.05）.结论：LE组促排卵效果好,卵泡可能与子宫内膜同步发育,促排卵后临床妊娠率高,有望成为新的一线促排卵药.

Objective：To investigate the effects of letrozole （LE） on the ovulation in patients with polycystic ovary syndrome （PCOS）. Methods ： The patients with good follicular growth and nomal ovulation after taking ovulation stimulator for 44 cycles were divided into letrozole group and clomifene（CC） group. The LE group with 20 cycles took 5 mg of LE per day for 5 days at the fifth day of menstrual cycle or withdrawal bleeding by oral. The CC group with 24 cycles took 100 mg of CC per day for 5 days at the fifth day of menstrual cycle or withdrawal bleeding by oral. The clinical pregnancy rate and early pregnancy abortion rate of two groups were compared. Results：Compared with the CC group, the endometrial thickness and clinical pregnancy rate of LE group with human chorionic gonadotropin period was higher, its serum estradiol level was lower （P 〈 0.05 to P 〈0.01 ）. There were not statistical differences in dominant follicle number, serum luteinizing hormone level, serum progesterone, three line rate of endometrium and early pregnancy abortion rate between two groups （ P 〉 0. 05 ）. Conclusions ： The effect of LE on promoting ovulation is good, the development of follicle and endometrium is synchronous. The clinical pregnancy rate is high after promoting ovulation. The LE may be a promising promoting ovulation drug.