[1]焦守凤*,刘桂娟,李娜.来曲唑、克罗米芬单用或联合应用对多囊卵巢综合征不孕症患者尿促性素用量及排卵效果的影响[J].中国计划生育和妇产科,2018,(8):75-78.
　JIAO Shou-feng*,LIU Gui-juan,LI Na.Influence of alone or combined use of letrozole and clomiphene citrate on the dosage of gonadotrophin and ovulation induction effect in infertility patients[J].Chinese Journal of Family Planning & Gynecotokology,2018,(8):75-78.
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来曲唑、克罗米芬单用或联合应用对多囊卵巢综合征不孕症患者尿促性素用量及排卵效果的影响
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年8期
页码:
75-78
栏目:
论著与临床
出版日期:
2018-08-25

文章信息/Info

Title:
Influence of alone or combined use of letrozole and clomiphene citrate on the dosage of gonadotrophin and ovulation induction effect in infertility patients
作者:
焦守凤1*; 刘桂娟1; 李娜2
衡水市第二人民医院，1不孕不育科；2妇产科
Author(s):
JIAO Shou-feng1*;  LIU Gui-juan1;  LI Na2
1. Department of Infertility； 2. Department of Obstetrics and Gynecology, the Second People's Hospital of Hengshui, Hengshui Hebei 053000, P.R.China
关键词:
多囊卵巢综合征不孕症; 来曲唑; 克罗米芬; 尿促性素; 排卵率; 妊娠结局
Keywords:
polycystic ovary syndrome; infertility; letrozole; clomiphene citrate;  human menopausal gonadotropin;  ovulation rate;  pregnancy outcome
分类号:
R 7116
摘要:
目的探讨来曲唑（letrozole,LE）、克罗米芬（clomiphene citrate,CC）单用或联合应用对多囊卵巢综合征（polycystic ovary syndrome,PCOS）不孕症患者尿促性素（human menopausal gonadotropin,HMG）用量及排卵效果的影响。方法回顾性分析2014年1月至2016年1月衡水市第二人民医院收治的PCOS不孕症患者300例的病例资料，根据用药方案分为CC组（100例）、LE组（100例）、CC+LE组（100例）。3组每个治疗周期中，如无优势卵泡发育，加用HMG肌注，比较3组促排卵效果、人绒毛膜促性腺激素（human chorionic gonadotrophin,hCG）日子宫内膜厚度、成熟卵泡个数、最大卵泡直径及妊娠结局。结果3组hCG日最大卵泡直径、流产发生率比较，差异无统计学意义（P＞005），CC+LE组诱排时间短于CC组、LE组（P＜005），CC+LE组排卵率（910 %）高于CC组（780 %）（P＜005），CC组与LE组、LE组与CC+LE组比较，差异无统计学意义（P＞005）；CC+LE组HMG用量少于CC组、LE组，LE组少于CC组，差异有统计学意义（P＜005）。CC+LE组、LE组子宫内膜厚度高于CC组（P＜005），CC+LE组与LE组比较，差异无统计学意义（P＞005）；CC+LE组成熟卵泡个数少于CC组，多于LE组，LE组成熟卵泡个数少于CC组，3组比较差异有统计学意义（P＜005）。CC+LE组临床妊娠率（620 %）高于CC组（420 %）、LE组（480 %）（P＜005），CC组的多胎妊娠率为80 %，高于LE组（0），卵巢过度刺激综合征发生率（80 %）高于CC+LE组（20 %），差异有统计学意义（P＜005）。结论与CC、LE单独促排卵相比，CC+LE促排卵治疗PCOS不孕症可缩短诱排时间，减少HMG用量，提高排卵率和妊娠率。
Abstract:
ObjectiveTo investigate the influence of alone or combined use of letrozole(LE) and clomiphene citrate(CC) on the dosage of human menopausal gonadotropin(HMG) and ovulation induction effect in infertility patients with polycystic ovary syndrome(PCOS). MethodsThe medical data of 300 infertility patients with PCOS treated in the Second People's Hospital of Hengshui from January 2014 to January 2016 were analyzed retrospectively. They were divided into CC group(n=100), LE group(n=100) and CC+LE group(n=100) according to different medication regimens. The three groups were treated by muscular injection with HMG when there was no dominant follicle development in every treatment cycle. The ovulation induction effect, the endometrial thickness on the day of injecting human chorionic gonadotrophin(hCG), the number of mature follicles, the maximum follicular diameter and pregnancy outcomes were compared among the three groups. ResultsThere was no statistically significant difference in the maximum follicle diameter on the day of injecting hCG and the incidence of abortion among the three groups(P>005). The induction time of CC+LE group was shorter than that of CC group and LE group(P<005). The ovulation rate of CC+LE group was higher than that of CC group (910% vs 780%)(P<005), and there was no statistically significant difference in the rate between CC group and LE group, and between LE group and CC+LE group(P>005).The dosage of HMG in the three groups ranking from low to high were CC+LE group, LE group and CC group(P<005). The endometrial thickness in CC+LE group and LE group was higher than that in CC group(P<005), but there was no significant difference between CC+LE group and LE group(P>005). The number of mature follicles in CC+LE group was smaller than that in CC group and larger than that in LE group. The number of mature follicles in LE group was smaller than that in CC group(P<005). The clinical pregnancy rate of CC+LE group was higher than that in CC group and LE group (620 % vs 420 %, 480 %)(P<005), and the rate of multiple pregnancy in CC group was higher than that in LE group (80 % vs 0), and the incidence rate of OHSS was higher than that in CC+LE group (80 % vs 20 %) (P<005). ConclusionCompared with CC or LE alone inducing ovulation, CC combined with LE ovulation induction treatment for PCOS with infertility can shorten the induction time, reduce the dosage of HMG, and increase the ovulation rate and pregnancy rate.

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更新日期/Last Update: 2018-08-25