来曲唑应用于多囊卵巢综合征促排卵治疗的研究进展

Application of Letrozole in Ovulation Induction Therapy for Polycystic Ovary Syndrome

来曲唑(letrozole,LE)是第三代芳香化酶抑制剂(aromatase inhibitors,AIs),为人工合成的三苯三喹类衍生物。2001年国外首次将LE正式应用于临床促排卵治疗。多囊卵巢综合征(polycystic ovary syndrome,PCOS)是育龄期妇女常见的生殖内分泌和代谢紊乱疾病,无排卵是其主要特征,为不孕不育的直接原因之一。临床上促排卵治疗药物首选氯米芬(clomiphene citrate,CC),但CC因一些不良反应而具有局限性。研究发现,在PCOS妇女不孕治疗中,LE可以促进子宫内膜生长,对宫颈黏液无不利影响,为胚胎种植提供良好条件;且LE在排卵率与出生率方面优于CC,在流产率、多胎妊娠率及对胎儿安全性方面LE和CC相似。因此,在PCOS妇女不孕治疗中,LE或可取代CC成为一线的促排卵药物。

Letrozole （LE） was a third-generation aromatase inhibitor （AIs）, which is a kind of artificially synthesized triphenyl quinoline derivative. It was firstly used in the clinical treatment of ovulation induction clomiphene citrate in 2001. Polycystic ovary syndrome （PCOS） is a reproductive endocrinology and metabolic disorders commonly found in the women of reproductive age, with the main character of ovulation, which is one of the direct causes of infertility. Clomiphene citrate （CC） has been presently used as the first choice in the treatment of ovulation induction. Due to some side effects of CC, there were some limitations in its clinical application. The study found that LE can promote the endometrial growth in the infertility treatment of PCOS women, without any adverse effects on cervical mucus, which provides good condition for embryo implantation. Also, LE was better than CC in the ovulation rate and birth rate. However, there were no significant diffeences in the abortion rate, multitle-gestation pregnancy rate and the fetal safety between LE and CC. Therefore, LE may be used as the first- line drug of ovulation induction in the infertility treatment of PCOS women, to replace CC potentially.