国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2013, Vol. 32 ›› Issue (4): 290-292.

• 论著 • 上一篇    下一篇

来曲唑治疗氯米芬抵抗的多囊卵巢综合征临床观察


杨峥莉 ,刘荣霞, 郝国荣   

  1. 050011 石家庄市第四医院妇科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-07-15 发布日期:2013-07-15

Efficacy of Letrozole in Clomiphene-resistant Infertile Women with Polycystic Ovarian Syndrome

YANG Zheng-li，LIU Rong-xia，HAO Guo-rong   

  1. Department of Obstetrics and Gynecology，The Forth Hospital of Shijiazhuang，Shijiazhuang 050011，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-07-15 Online:2013-07-15

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摘要： 目的：评价来曲唑（LE）对氯米芬抵抗的多囊卵巢综合征（PCOS）患者促排卵的临床效果。方法：选择2010年1月—2011年1月于我院就诊的氯米芬抵抗的PCOS患者88例，随机分为3组，LE组在月经周期第3～7天口服LE 2.5 mg/d，人绝经期促性腺激素（HMG）组在月经周期第5天开始肌内注射75 IU/d HMG，根据卵泡长势调整HMG用量；LE+HMG组月经周期第3～7天用LE 2.5 mg/d，周期第7天加用HMG 75 IU/d，根据卵泡长势调整HMG用量。超声监测卵泡发育，当最大卵泡平均直径≥18 mm时，肌内注射人绒毛膜促性腺激素（hCG）5 000 IU诱发排卵，观察子宫内膜厚度及形态、排卵率和妊娠率。结果：3组的排卵率和周期妊娠率差异无统计学意义（P＞0.05），LE组及LE+HMG组单个优势卵泡的发生率明显高于HMG组，其成熟卵泡数低于HMG组（P＜0.05），3组在hCG日子宫内膜的厚度差异无统计学意义（P＞0.05）。结论：LE用于氯米芬抵抗引起的PCOS患者具有良好的排卵率和妊娠率，与单独使用HMG促排卵相比较，LE联合HMG促排卵能在取得相似排卵率的情况下减少HMG用量。

关键词: 多囊卵巢综合征, 氯米芬, 促生育素类, 氯米芬抵抗

Abstract: Objective： To evaluate the clinical efficacy of letrozole in treatment of clomiphene-resistant women with polycystic ovarian syndrome （PCOS）. Methods：Eighty-eight clomiphene-resistant women with PCOS were enrolled in this prospective，randomized，open-labeled study between Jan. 2010 and Jan. 2011. All subjects were divided into three groups andomly：the Letrozole group received Letrozole （LE） 2.5 mg/d per os for 5 days during days 3-7 of menstrual circle，the control group was administered HMG progressive increasing from 75 IU/d intramuscular. for ovulation induction on day 5 of menstrual circle；the LE+HMG group was treated with LE 2.5 mg/d for 5 days during days 3-7 of menstrual circle，from day 8，then treated with HMG 75 IU/d intramuscular. The transvaginal ultrasonography was applied to observe follicle growth and ovulation. When the follicular diameter was ≥18 mm in length，hCG （5000 IU） was injected to induce ovalution. Ovulation rate，pregnancy rate and the endometrial thickness were observed. Results：Ovulation rate and pregnacy rate were similar in three groups. The incidences of single dominant follicle in LE group and LE+HMG group were significantly higher than that in HMG group （P＜0.05），while the numbers of mature follicles in the LE group and LE+HMG group were lower than that in the HMG group. There was insignificant difference in endometrial thickness at the day of hCG injection among three groups. Conclusions：Letrozole can get good ovulation rate and pregnancy rate in those clomiphene-resistant women with PCOS. Compared with HMG alone，LE combined with HMG on the controlled ovarian stimulation can get higher ovulation rate with the lowered dose of HMG.

Key words: Polycystic ovary syndrome, Clomiphene, Menotropins, Clomiphene citrate-resistant