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目的:比较两种不同剂量来曲唑(LE)对多囊卵巢综合征(PCOS)不孕患者促排卵的效果及其对生殖激素影响。方法:拟行促排卵治疗的151例PCOS不孕症患者随机分为两组,于月经周期第3～7天A组69例每天口服LE 2.5 mg和B组82例每天口服LE 5.0 mg。超声监测卵泡发育,并于月经周期第8天和绒促性素(HCG)注射日取静脉血测定黄体生成素(LH)、雌二醇(E2)、睾酮(T);观察优势卵泡数、成熟卵泡数、排卵率、妊娠率、子宫内膜厚度、多胎妊娠率、卵巢过度刺激综合征(OHSS)发生率及生殖激素变化。结果:HCG日优势卵泡个数、成熟卵泡个数B组多于A组,卵泡成熟时间B组少于A组,两组比较差异有统计学意义(P<0.05)。周期妊娠率B组高于A组,两组比较差异有统计学意义(P<0.01)。排卵率、HCG日子宫内膜厚度两组比较差异无统计学意义(P>0.05)。两组均未发生多胎妊娠及OHSS。结论:B组优势卵泡个数、成熟卵泡个数及周期妊娠率优于A组。
OBJECTIVE: To compare the effects of two different doses of letrozole (LE) on ovulation induction in women with PCOS infertility and its effects on reproductive hormones. Methods: One hundred and fifteen patients with PCOS infertility who were treated by ovulation induction were randomly divided into two groups. On the 3rd to 7th days of the menstrual cycle, 69 patients in group A received LE 2.5 mg daily and 82 patients in group B received daily oral LE 5.0 mg. The ovarian follicles were monitored by ultrasound and venous blood was collected on the 8th day of the menstrual cycle and on the day of HCG injection for determination of LH, estradiol (E2) and testosterone (T). The number of dominant follicles, The number of mature follicles, ovulation rate, pregnancy rate, endometrial thickness, multiple pregnancy rate, ovarian hyperstimulation syndrome (OHSS) incidence and reproductive hormone changes. Results: The number of dominant follicles and the number of mature follicles in HCG group B were more than that in A group, while follicle maturation time in B group was less than that in A group. There was significant difference between the two groups (P <0.05). The rate of pregnancy in group B was higher than that in group A, the difference was statistically significant (P <0.01). Ovulation rate, HCG endometrial thickness between the two groups showed no significant difference (P> 0.05). No multiple pregnancy and OHSS occurred in either group. Conclusion: The number of dominant follicles, the number of mature follicles and the rate of pregnancy in group B are better than those in group A.