尿促卵泡素联合来曲唑治疗多囊卵巢综合征致不孕症患者的效果

Effects of Urofollitropin combined with Letrozole in treatment of infertility caused by polycystic ovary syndrome

目的:探讨尿促卵泡素联合来曲唑治疗多囊卵巢综合征(PCOS)致不孕症患者的效果。方法:选取2021—2022年该院收治的70例PCOS致不孕症患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各35例。对照组口服来曲唑片治疗,研究组在对照组基础上肌内注射尿促卵泡素治疗。比较两组治疗前后血清性激素[雌二醇(E_(2))、黄体生成素(LH)、卵泡刺激素(FSH)]水平、内分泌指标[胰岛素样生长因子1(IGF-1)、性激素结合球蛋白(SHBG)]水平、排卵率、妊娠率及不良反应发生率。结果:治疗后,两组血清E_(2)水平均低于治疗前,但组间比较差异无统计学意义(P>0.05);两组血清LH、FSH水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);治疗后,研究组血清IGF-1水平低于对照组,SHBG水平高于对照组,差异均有统计学意义(P<0.05);治疗3个周期后,研究组排卵率为82.86%(29/35),高于对照组的54.29%(19/35),随访6个月后,研究组妊娠率为37.14%(13/35),高于对照组的14.29%(5/35),差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:尿促卵泡素联合来曲唑治疗PCOS致不孕症患者,可有效改善性激素水平,调控IGF-1、SHBG的表达,提高排卵率和妊娠率,效果优于单用来曲唑治疗。

Objective:To investigate effects of Urofollitropin combined with Letrozole in treatment of infertility caused by polycystic ovary syndrome(PCOS).Methods:A prospective study was conducted on 70 patients with infertility caused by PCOS admitted to this hospital from January 2021 to December 2022.According to the random number table method,they were divided into study group and control group,35 cases in each group.The control group was treated with oral Letrozole tablets,while the study group was treated with intramuscular injection of Urofollitropin on the basis of that of the control group.The levels of serum sex hormones[estradiol(E_(2)),luteinizing hormone(LH),follicle stimulating hormone(FSH)]and endocrine indexes[insulin-like growth factor 1(IGF-1),sex hormone binding globulin(SHBG)],the ovulation rate,the pregnancy rate,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:After the treatment,the levels of E_(2) in the two groups were lower than those before the treatment,but there was no significant difference between the two groups(P>0.05).The levels of LH and FSH in the two groups were higher than those before the treatment,those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the serum IGF-1 level in the study group was lower than that in the control group,the SHBG level was higher than that in the control group,and the differences were statistically significant(P<0.05).After 3 cycles of treatment,the ovulation rate of the study group was 82.86%(29/35),which was higher than the control group of 54.29%(19/35);after 6 months of follow-up,the pregnancy rate of the study group was 37.14%(13/35),which was higher than the control group of 14.29%(5/35);and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Urofollitropin combined with Letrozole in the treatment of infertility caused by PCOS can effectively improve the levels of sex hormones,regulate the expression of IGF-1 and SHBG,and improve the ovulation rate and the pregnancy rate.Moreover,it is superior to single Letrozole treatment.