来曲唑联合HMG在多囊卵巢综合征患者超排卵中的研究

目的比较多囊卵巢综合征（PCOS）患者应用来曲唑（LE）联合人绝经后促性腺激素（HMG）与单用HMG促排卵效果,探讨PCOS适宜的促排卵方案。方法选择拟行促排卵PCOS患者112例,分为两组：HMG组（67例,126个周期）和LE＋HMG组（45例,86个周期）。HMG组：月经第3d始予HMG75IU/d至HCG日。HMG＋LE组：月经第3d始予LE5mg,连用5d,第7d始加用HMG75IU/d至HCG日。计算HMG总剂量及天数、测定HCG日成熟卵泡数、子宫内膜厚度及E2水平、临床妊娠率及卵巢过度刺激综合征（OHSS）发生率。结果 HMG组的HMG用量、HCG日成熟卵泡数、E2水平、OHSS发生率均高于LE＋HMG组（P〈0.05或P〈0.01）;而促排卵天数、子宫内膜厚度、临床妊娠率两组比较无统计学意义。结论来曲唑联合HMG可能是PCOS患者的一种更为安全、经济、有效的促排卵方案。

Letrozole combined with HMG for inducing ovulation in women with polycystic ovarian syndrome

Objective To explore the suitable ovarian stimulation protocol by comparing the efficacy of letrozole（LE） with human menopausal gonadotropin（HMG） or HMG in treatment of polycystic ovarian syndrome（PCOS）.Methods 112 PCOS women were randomized into two groups received either HMG（126 cycles） or LE-HMG（86 cycles）.HMG group： HMG dose of 75 IU/ml administered every day starting at third day until hCG day.LE-HMG group： Letrozole dose of 5 mg/d was given on day 3-7 of the menstrual cycles and combined with HMG dose of 75 IU/ml administered every day starting at 7th day.Main outcome measures included dose of HMG used per cycle,the number of mature follicles,endometrial thickness,serum E2 on hCG day,Clinical pregnancy rate and OHSS rate.Results The total doses,the number of mature follicles,serum E2 and the rate of OHSS in HMG group were higher than those in LE-HMG group.There were no differences in the duration of ovarian stimulation,endometrial thickness and clinical pregnancy rate between two groups.Conclusion LE-HMG seems to be safer,more cost-effective ovulation stimulation protocol in PCOS women.