氯米芬与来曲唑在多囊卵巢综合征不孕患者中促排卵作用比较

目的探讨枸橼酸氯米芬(CC)和来曲唑(LE)在多囊卵巢综合征(PCOS)不孕患者中促排卵的作用。方法选择2014年1月至2015年12月在上海市沃德医疗中心就诊的PCOS不孕患者,随机分为研究组(n=120)和对照组(n=115)。研究组和对照组分别在月经第3天开始应用LE 5 mg和CC 100 mg促排卵,应用5 d后停药,并在至少一个卵泡直径达20 mm时注射10 000 IU的h CG。比较两组患者直径≥14 mm卵泡(优势卵泡)数、直径≥18 mm卵泡数及注射h CG时子宫内膜厚度、促排卵后内分泌指标、周期妊娠率等。结果研究共纳入235例PCOS患者,给予LE促排卵(研究组)的120例中,39例妊娠,周期妊娠率为32.5%,给予CC促排卵(对照组)的115例中,15例妊娠,周期妊娠率为13.0%,两组间比较差异有统计学意义(P<0.01)。注射h CG时,对照组子宫内膜厚度(9.4±0.2)mm,高于观察组的(8.0±0.3)mm,差异有统计学意义(P<0.05)。促排卵后,对照组组患者的血清雌激素、孕激素和黄体生成素水平均高于观察组,而FSH水平和AMH水平低于观察组,差异均有统计学意义(P<0.05)。结论与对照组比较,应用LE对PCOS不孕患者进行促排卵治疗,对子宫内膜影响小,周期妊娠率高。

Comparison of the efficacy between clomiphene citrate and letrozole on ovulation induction in infertile patients with polycys-tic ovary syndrome

Objective To compare the efficacy of clomiphene( CC) and letrozole( LE) on ovulation induction in infertile of polycystic ovary syndrome( PCOS) . Methods Infertile women with polycystic ovary syndrome( PCOS) who visited Worldpath Clinic International were randomized to treatment with 5 mg of letrozole daily or 100 mg clomiphene daily for 5 days,respectively,starting on 3rd day of menses,and were injected 10000 IU hCG in at least one follicle with a diameter of 20 mm. The number of follicle≥14 mm,number of follicle≥18 mm,thickness of endometrium on day of hCG injection,endocrine index and rate of period pregnancy were compared be-tween the two groups. Results The study comprised a total of 235 patients,including 120 in LE group and 115 in CC group. The peri-od pregnancy rate was 32. 5% in LE group and 13. 0% in CC group,with a significant difference between two groups(P<0. 01). The thickness of endometrium on day of hCG injection in CC group was significantly higher than that in LE group(P<0. 05). After ovula-tion induction,the level of serum estrogen, progesterone and LH in CC group were significantly higher than that in LE group ( P <0. 05),while the level of FSH and AMH in CC group were significantly lower than that in LE group(P<0. 05). Conclusion In ovu-lation induction of PCOS,LE has less impact on endometrium and better efficacy on period pregnancy rate than CC.