来曲唑和克罗米芬微刺激方案在卵巢功能低下患者助孕结局比较

目的:比较来曲唑(LE)和克罗米芬(CC)两种微刺激方案对卵巢储备功能低下患者的助孕结局。方法:对珠海市妇幼保健院生殖中心2012年1月～10月接受体外受精-胚胎移植(IVF-ET)治疗的171个新鲜周期的资料进行回顾性分析。其中LE组47个周期,CC组124个周期。比较两组在年龄、不育年限、基础卵泡刺激素(FSH)水平、人绒毛膜促性腺激素(HCG)日血清雌激素(E2)水平、孕激素(P)水平、HCG日内膜厚度、获卵数、未获卵周期率、可移植胚胎数、种植率、临床妊娠率、流产率的差异。结果:LE组的种植率为35.4%、临床妊娠率为31.9%,均明显高于CC组(P<0.01);LE组血清E2水平显著低于CC组(P<0.01);而HCG日内膜厚度则明显高于CC组(P<0.01)。LE组的年龄、不育年限、基础FSH水平、HCG日血清P水平、未获卵周期率、获卵数、可移植胚胎数、流产率与CC组比较差异无统计学意义(P>0.05)。结论:两种微刺激方案对于卵巢储备功能低下患者均有一定效果,但LE组的临床结局可能更好。

Comparison of clinical outcome of mild stimulation protocol with letrozole and clomiphene in ovarian insufficiency patients

Objective:To compare the clinical outcome of mild stimulation protocol with letrozole(LE) and clomiphene(CC) in ovarian insufficiency patients.Methods:171 cycles from infertile patients who underwent in vitro fertilization-embyo transfer(IVF-ET) at Zhuhai Maternal and Children's Hospital and Health Institute from January to October 2012 were retrospectively analyzed.The patients were divided into LE group(administrated with letrozole,n=47) and CC group(administrated with clomiphene,n=124).The difference of clinical outcome was compared and analyzed between the two groups.Results:The implantation rate in LE group was 35.4%,the clinical pregnancy rate was 31.9%,they were higher than those of CC group,the difference was statistically significant(P<0.01).The serum estradiol(E2) value on human chorionic gonadotropin(HCG) day in LE group was significantly lower than that in CC group,the difference was statistically significant(P<0.01).The endometrial thickness on HCG day was higher than that of CC group,the difference was statistically significant(P<0.01).No statistically significant difference was found between the two groups in age,infertility time,basic follicle stimulating hormone(FSH) value,progesterone(P) value on HCG day,cancellation rate,oocyte numbers,transferable embryo numbers,abortion rate(P>0.05).Conclusion:Both mild stimulation protocols are effective to patients with ovarian insufficiency,but the clinical outcome might be better in LE group.