来曲唑联合尿促性素治疗多囊卵巢综合征不孕症患者的临床观察

目的评估来曲唑（LE）联合尿促性素（HMG）低剂量方案治疗多囊卵巢综合征（PCOS）耐克罗米芬（CC）无排卵不孕症的有效性和安全性。方法对60例耐CC的PCOS不孕症患者进行110个周期LE联合HMG低剂量方案促排卵治疗,以阴道B超和血雌二醇（E2）水平作为监测卵泡发育的指标。结果除3例因卵泡发育数目大于8个而终止、1例卵泡不发育而放弃外,其余周期均排卵,30个周期为单卵泡发育。在60例患者中,有28例单胎妊娠,2例双胎妊娠,无多胎妊娠,无重度卵巢过度刺激综合征（OHSS）发生,无局部及全身不良反应。结论 LE联合HMG低剂量方案是治疗耐CC的PCOS无排卵不孕症有效而安全的排卵选择。适时准确的阴道B超是适时调整剂量减少治疗中止、防止OHSS的有效措施。

Clinical Study of Letrozole Combi ned HMG in the Treatment of Polycystic Ovary Syndrome Related Infertility with Clomiphene Resistance

OBJECTIVES To assess the efficacy and safety of letrozole combined low dose human menopausal gonadotropins （HMG） protocol in ovulation induction of polycystic ovary syndrome related infertile patients with clomiphene（CC）resistance. METHODS 60 PCOS related infertile patients with CC resistance were enrolled for ovulation induction by letrozole combined low dose HMG protocol,using urinary HMG（Menotrophin） 110 cycles. Follicular development was monitored by transvaginal ultrasonography and serum estradiol （E2） detection. RESULTS 106 out of 110 cycles ovulated ,among them 30 had monofollicle development. 28 patient achieved single pregnancy,2 twin gestation. No severe ovarian hyperstimulation syndrome（OHSS）,local or systemic side effect was seen. CONCLUSIONS Letrozole combined low dose HMG protocol is an effective and safe choice in inducing ovulation for CC-resistant PCOS infertile case. Transvaginal ultrasonography is important for appropriate dose adjustment and avoidance of cancellation or OHSS.