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目的比较来曲唑(LE)、克罗米芬(CC)和尿促性素(HMG)在多囊卵巢综合征(PCOS)促排卵中的效果,探讨LE在PCOS促排卵中的优势。方法有生育要求的PCOS患者150例,共239个促排卵周期,随机分为CC组、LE组、CC+HMG组、LE+HMG组和HMG组。比较各组患者绒促性素(HCG)注射日成熟卵泡(卵泡直径≥14 mm)的数量、多于3个卵泡的例数、排卵率、卵泡不破裂黄素化综合征(LUFS)发生率、HCG注射日子宫内膜的厚度、尿促性素用量、诱导排卵时间、周期妊娠率。结果 LE组和LE+HMG组患者HCG注射日成熟卵泡的数量和多于3个卵泡的例数均显著低于其他3组(P<0.05);CC组排卵率均低于其他4组,而LUFS的发生率高于其他4组(P<0.01);LE组、LE+HMG组和HMG组HCG注射日子宫内膜的厚度均显著高于其他2组(P<0.05);LE+HMG组中HMG的用量低于CC+HMG和HMG组(P<0.05);HMG组诱导排卵时间显著长于其他4组(P<0.05);CC组妊娠率明显低于其他4组(P<0.05)。结论在PCOS促排卵中,LE较CC和HMG排卵率高,LUFS发生率低,单卵泡发育率高,HCG注射日子宫内膜的厚度高,妊娠率高,节约促排卵时间和费用。
Objective To compare the effects of letrozole (LE), clomiphene citrate (CC) and urinary hgroproline (HMG) on ovulation induction in women with polycystic ovary syndrome (PCOS) and to explore the advantages of LE in promoting ovulation by PCOS. Methods 150 cases of PCOS patients with reproductive requirements, a total of 239 ovulation cycles, were randomly divided into CC group, LE group, CC + HMG group, LE + HMG group and HMG group. The number of mature follicles (follicle diameter≥14 mm), number of more than three follicles, ovulation rate, incidence of non-ruptured luteinizing syndrome (LUFS), HCG The thickness of the endometrium on the day of injection, the amount of urotensin, the time of ovulation induction, and the rate of periodic pregnancy. Results The number of mature follicles and the number of more than three follicles in HCG injection group and LE + HMG group were significantly lower than those in other three groups (P <0.05). The ovulation rate in CC group was lower than that in the other four groups The incidence of LUFS was higher than other four groups (P <0.01). The thickness of endometrium on the day of HCG injection in LE group, LE + HMG group and HMG group were significantly higher than those in other two groups (P <0.05) HMG was lower than that of CC + HMG and HMG groups (P <0.05). The ovulation induction time in HMG group was significantly longer than the other 4 groups (P <0.05). The pregnancy rate in CC group was significantly lower than that in the other 4 groups (P <0.05). Conclusions In ovulation induction of PCOS, the ovulation rate of LE is higher than that of CC and HMG, the incidence of LUFS is low, the rate of single follicle development is high, the thickness of endometrium on HCG injection is high, the pregnancy rate is high, and the ovulation time and cost are reduced.