来曲唑联合HMG对多囊卵巢综合征患者促排卵的疗效观察

目的 比较来曲唑（LE）联合人绝经期促性腺素（HMG）和单用HMG对多囊卵巢综合征（polycystic ovarian system,PCOS）患者促排卵的临床效果.方法 回顾58例PCOS不孕患者58个促排卵周期,随机分为LE联合HMG组（A组）24个周期和单用HMG组（B组）34个周期,A组于月经周期第3～7天口服来曲唑2.5 mg/d,第8天肌注HMG 75 IU/d;B组于月经第3天始肌注HMG 75 IU/d,用药至卵泡成熟,肌注HCG诱发排卵.分析两组患者HCG日成熟卵泡数、子宫内膜厚度、单成熟卵泡发育率、HMG用量、临床妊娠率、流产率、多胎率、卵巢过度刺激综合征（OHSS）发生率及肥胖对妊娠的影响.结果 A组和B组患者HCG日子宫内膜厚度及临床妊娠率差异无统计学意义（P＞0.05）;比较两组HCG日优势卵泡数目、单成熟卵泡发育率及HMG用量,差异有统计学意义（P＜0.05）.结论 LE联合HMC和单用HMG促排卵能获得相似的妊娠率,LE联合HMG促排卵可以减少HMG药物用量,降低多胎和OHSS风险.

Efficacy of letrozole combined human menopausal gonadotropin in ovulation induction in patients with polycystic ovary syndrome

Objective： To compare the clinical outcomes of human menopausal gonadotropin （HMG） and letrozole （LE） ＋ HMG for ovulation induction among women with polycystic ovary syndrome （PCOS）. Methods： Fifty-eight ovulation cycles of 58 patients with PCOS were respectively studied and treated with LE ＋ HMG （Group A, n = 24）and only HMG randomly （Group B, n =34）. Group A were treated with LE 2.5mg from the third day to the seventh day during menstrual cycle and with HMG 75 IU im qd from the eighth day, while Group B were given HMG 75 ~ 150 IU from the third day till the follicular diameter was I〉 18 mm in length, and then HCG 6000 ~ 10000 IU was injected to induce ovalution. The number of follicles, endometrial thickness, mono mature follicle rates per cycle, dose of HMG used per cycle and pregnancy rates per cycle were compared among both of the groups. Results： No significant differences were found in the number of follicles, endometrial thickness and pregnancy rates per cycle （ P 〉 0.05 ）. Significant differences were found in mono mature follicle rates per cycle, the dosage of HMG used per cycle among both of the groups（P 〈 0.05）. Conclusion ： The protocols of LE ＋ HMG produce a similar pregnancy rate with that of HMG. This protocol can reduce the dosage of HMG and the risks of multiple pregnancy and OHSS.