来曲唑联合尿促性素治疗多囊卵巢综合征不孕症患者的临床疗效

Effect of letrozole combined with menotropins on ovulation induction in infertile patients with polycystic ovary syndrome

目的探讨来曲唑联合人绝经期促性腺激素(HMG)在不同给药时机治疗多囊卵巢综合征(PCOS)不孕症患者的临床疗效。方法选取88例行来曲唑促排卵治疗失败的PCOS不孕症患者,采用信封法进行分配隐匿分为A组与B组,各44例。所有患者均在月经第3~7天口服来曲唑5 mg/d,A组从月经第4天开始隔日肌内注射75 IU HMG,连续3 d。B组从月经第8天开始,每天肌内注射75 IU HMG,连续3 d。观察比较两组患者的促排卵效果和妊娠结局。结果A组的HMG使用天数、用量、多胎妊娠率、早期流产率均低于B组,差异无统计学意义(P>0.05)。两组的排卵率、临床妊娠率、周期取消率、卵巢过度刺激综合征(OHSS)发生率、子宫内膜厚度、血清雌二醇水平及优势卵泡个数比较,差异均无统计学意义(P>0.05)。结论来曲唑联合HMG在不同给药时机均可明显改善PCOS不孕症患者的卵泡发育和排卵,两种方案均可应用于PCOS不孕患者的临床治疗。

Objective To investigate the clinical efficacy of letrozole combined with human menopausal gonadotropin(HMG)on infertile in patients with polycystic ovary syndrome(PCOS).Methods 88 infertile PCOS patients who failed to receive letrozole ovulation induction treatment we re selected and allocated by envelope method into group A and group B,44 cases in each group.All patients received oral letrozole 5 mg/d on the 3rd to 7th day of menstruation,and group A received intramuscular injection of 75 IU HMG every other day from the 4th day of menstruation for 3 consecutive days.Group B received intramuscular injection of 75 IU HMG daily for 3 consecutive days starting from the 8th day of menstruation.The ovulation promoting eff ect and pregnancy outcome of the two groups were observed and compared.Results The number of days,dosage,multiple pregnancy rate and early abortion rate of HMG in group A were lower than those in group B,with no statistical signifi cance(P>0.05).There were no signifi cant differences in ovulation rate,clinical pregnancy rate,cycle cancellation rate,incidence of ovarian hyperstimulation syndrome(OHSS),endometrial thickness,serum estradiol level and number of dominant follicles between 2 groups(P>0.05).Conclusion Letrozole combined with HMG can significantly improve follicular development and ovulation in PCOS infertility patients at different administration times,and both schemes can be applied to the clinical treatment of PCOS infertility patients.