单纯来曲唑促排卵方案用于多囊卵巢综合征患者冻融移植周期的临床价值

The clinical value of letrozole alone for ovulation promotion in patients with polycystic ovary syndrome during freeze-thaw transplantation cycle

目的比较单纯口服来曲唑促排卵方案与人工周期方案用于多囊卵巢综合征(PCOS)不孕患者冻融移植(FET)周期的优缺点,探讨来曲唑应用于PCOS患者FET周期的临床价值。方法回顾性分析538例PCOS不孕患者首次行冻融单囊胚移植的临床资料。根据子宫内膜准备方案分为2组,其中来曲唑组114例,单纯口服来曲唑促排卵;人工周期组424例,行人工周期方案。对2组患者的一般资料、临床结局等数据进行统计分析。结果来曲唑组转化日E_(2)水平[(253.5±40.6)pg/mL vs.(169.4±31.5)pg/mL]、子宫内膜厚度[(10.1±2.6)mm vs.(8.9±3.5)mm]高于人工周期组,差异有统计学意义(P<0.05);来曲唑组临床妊娠率(67.5%vs.63.2%)、活产率(59.6%vs.51.2%)均略高于人工周期组,但差异无统计学意义(P>0.05);来曲唑组患者孕早期先兆流产率(7.7%vs.23.1%)、治疗总费用[(7331.7±99.8)元vs.(7739.2±60.5)元]低于人工周期组,差异有统计学意义(P<0.05);来曲唑组孕早期P水平[(16.3±5.8)ng/mL vs.(8.7±3.4)ng/mL]、平均就诊次数[(5.8±1.7)次vs.(3.1±0.3次)]高于人工周期组,差异有统计学意义(P<0.05);2组患者孕早期自然流产率、妊娠时间及新生儿出生体重差异均无统计学意义(P>0.05)。结论来曲唑促排卵方案可作为PCOS患者FET周期备选方案。

Objective To compare the advantages and disadvantages of oral letrozole for ovulation promotion and artificial cycle in the frozen-thaw transplantation(FET)cycle of infertile patients with polycystic ovarian syndrome(PCOS),and to explore the clinical value of letrozole in the FET cycle of PCOS patients.Methods The clinical datas of 538 infertile patients with PCOS undergoing frozen-thawed single blastocyst transfer for the first time were analyzed retrospectively.According to the endometrial preparation plan,they were divided into two groups,114 patients were included in the letrozole group,who were treated with letrozole alone to promote ovulation;424 patients were included in the artificial cycle group,who were treated with artificial cycle scheme.The general data and clinical outcomes of the two groups of patients were statistically analyzed.Results The E_(2) level[(253.5±40.6)pg/mL vs.(169.4±31.5)pg/mL]and endometrial thickness[(10.1±2.6)mm vs.(8.9±3.5)mm]in the letrozole group were significantly higher than those in the artificial cycle group(P<0.05);The clinical pregnancy rate(67.5%vs.63.2%)and live birth rate(59.6%vs.51.2%)in the letrozole group were slightly higher than those in the artificial cycle group,but the differences were not statistically significant(P>0.05).The threatened abortion rate(7.7%vs.23.1%)and total of treatment cost[(7331.7±100.8)yuan vs.(7739.2±60.5)yuan]in the letrozole group were significantly lower than those in the artificial cycle group(P<0.05);The level of P in early pregnancy[(16.3±5.8)ng/mL vs.(8.7±3.4)ng/mL]and the average number of visits[(5.8±1.7)times vs.(3.1±0.3)times]in the letrozole group were significantly higher than those in the artificial cycle group(P<0.05);There was no significant difference in spontaneous abortion rate,pregnancy time and newborn weight between the two groups(P>0.05).Conclusion Letrozole for ovulation promotion can be used as an alternative for FET cycle in patients with PCOS.