来曲唑与克罗米芬诱导排卵疗效比较

目的:观察来曲唑与克罗米芬诱导排卵的疗效。方法:将800例排卵障碍患者(2 186周期)随机分成两组,每组分别应用来曲唑(2.5 mg,1次/d,连用5天)或联合人绝经促性腺激素(HMG)、克罗米芬(50 mg,1次/d,连用5天)或联合HMG,观察、比较两组的排卵率、妊娠率、流产率等。结果:取消周期率、人绒毛膜促性腺激素(HCG)肌内注射日平均卵泡直径(MFD)≥15 mm的卵泡个数、卵巢过度刺激综合征(OHSS)发生率,两组相比差异无统计学意义(P>0.05)。单用来曲唑或克罗米芬的优势卵泡出现率:对于非多囊卵巢综合征(PCOS)的排卵异常病例,来曲唑组优于克罗米芬组,而对于PCOS者,来曲唑组则低于克罗米芬组;对于未破裂卵泡黄素化综合征(LUFS)病例,来曲唑组排卵率高于克罗米芬组;对于小卵泡排卵,肌内注射HCG日最大卵泡MFD:来曲唑组小于克罗米芬组;妊娠率来曲唑组高于克罗米芬组,而HCG肌内注射日子宫内膜厚度,克罗米芬组薄于来曲唑组,肌内注射HCG日子宫颈Insler评分克罗米芬组低于来曲唑组,早期流产率克罗米芬组高于来曲唑组,这些指标两组相比差异均有统计学意义。结论:来曲唑在诱导非PCOS患者出现优势卵泡、改善小卵泡排卵者的卵泡发育状况方面劣于克罗米芬,但排卵率、妊娠率高于克罗米芬,早期流产率低于克罗米芬。

Comparison of efficacies of letrozole and clomiphene in ovulation induction

Objective:To observe the efficacies of letrozole and clomiphene in ovulation induction.Methods:800 cases with ovulation dysfunction(2 186 cycles) were divided into two groups randomly,the women in the two groups were treated with letrozole(2.5 mg,once a day for 5 days) or combined with human menopausal gonadotropin(HMG),clomiphene(50mg,once a day for 5 days) or combined with HMG;the ovulation rates,pregnancy rates and abortion rates in the two groups were observed and compared.Results:There was no significant difference in cancellation rate of menstruation cycle,the amount of follicles with mean follicle diameter(MFD)≥15 mm on the day of intramuscular injection of HCG,the incidence of ovarian hyperstimulation syndrome(OHSS) between the two groups(P>0.05);the occurrence rate of dominant follicles of single letrozole group or clomiphene group: for the cases with ovulation dysfunction and without polycystic ovary syndrome(PCOS),the occurrence rate of dominant follicles in letrozole group was significantly higher than that in clomiphene group;for the cases with PCOS,the occurrence rate of dominant follicles in letrozole group was significantly lower than that in clomiphene group;for the cases with luteinizing unruptured follicle syndrome(LUFS),the occurrence rate of dominant follicles in letrozole group was significantly higher than that in clomiphene group.For the cases with small follicle ovulation,the largest MFD on the day of intramuscular injection of HCG in letrozole group was significantly lower than that in clomiphene group;the pregnancy rate in letrozole group was significantly higher than that in clomiphene group;the thickness of endometrium on the day of intramuscular injection of HCG in clomiphene group was significantly thinner than that in letrozole group;cervical Insler score on the day of intramuscular injection of HCG in clomiphene group was significantly lower than that in letrozole group;the early abortion rate in clomiphene group was significantly higher than that in letrozole group,there was significant difference in the above indexes between the two groups.Conclusion:Letrozole is inferior to clomiphene in aspects of inducing the occurrence of dominant follicles in cases without PCOS,improving follicular development of cases with small follicle ovulation,but the ovulation rate and pregnancy rate of letrozole are higher than those of clomiphene,and the early abortion rate of letrozole is lower than that of clomiphene.