来曲唑治疗克罗米酚低反应PCOS患者的疗效观察

目的观察克罗米酚低反应的多囊卵巢综合征患者使用来曲唑促排卵的疗效。方法21例对克罗米酚低反应的多囊卵巢综合征患者服用来曲唑促排卵，观察记录卵泡发育，注射人绒毛膜促性腺激素日子宫内膜厚度，宫颈黏液评分和血清雌二醇（E：）水平等指标，对来曲唑和克罗米酚治疗效果进行比较。结果和克罗米酚治疗组比较，来曲唑治疗组排卵率增加（66．7％vs32．4％），HCG日子宫内膜厚度增加，血清E2水平下降，宫颈黏液评分增加，差异有统计学意义（P〈0．01）。来曲唑组妊娠率14．3％。结论来曲唑用于克罗米酚低反应的多囊卵巢综合症患者诱导排卵有一定疗效。

Effectiveness of Letrozole for Iinduction of Ovulation in Polycystic Ovarian Syndrome (PCOS) Patients with an Inadequate Response to Clomiphene Ditrate

Objective To evaluate the effectiveness of letrozole for induction of ovulation in PCOS patients with an inadequate response to clomiphene citrate （CC）. Methods Twenty-one patients with anovulatory polycystic ovarian syndrome （PCOS） were included in this study, who had previously received CC with an inadequate outcome （no ovulation and/ or endometrial thickness of ≤ 0.5 cm）. The follicle diameter, endometrial thickness, the level of estradiol （E2） and the score of cervical mucus were monitored while the day of HCG injection. Results With letrozole treatment, ovulation occurred in 14/21 （66.7%） of cycles versus 12/37 （32.4%） of cycles with CC （P〈0.01）. The mean endometrial thickness was 7.3 mm with letrozole versus 5.8 rnm with CC （P 〈0.01）. The E2 level of group letrozole were significantly lower than that of group CC, and the cervical mucus score of group letrozole were significantly higher than that of group CC. Pregnancy were achieved in 3 letrozole patients（14.3%）. Conclusion Oral administration of the aromatase inhibitor letrozole is effective for ovulation induction in PCOS with a poor response to CC. Letrozole appears to avoid the unfavorable effects fi＇equently seen with antiestrogen used for ovulation induction.