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目的比较克罗米芬(CC)与来曲唑(LE)对多囊卵巢综合征(PCOS)患者促排卵治疗的作用及妊娠结局。方法 200例PCOS患者,随机分为LE组(90例)和CC组(110例)。两组均于月经周期第3~7天分别服用LE与CC,观察LE与CC对卵泡发育、子宫内膜及妊娠结局的影响。结果 LE组出现优势卵泡79例(87.78%)多于CC组的44例(40.00%),差异有统计学意义(P<0.05)。LE组单卵泡发育74例(93.67%)多于CC组15例(34.09%),差异有统计学意义(P<0.05)。LE组优势卵泡绒毛膜促性腺激素(HCG)注射日子宫内膜平均厚度为(8.28±1.89)mm,优于CC组的(5.79±1.49)mm,差异有统计学意义(P<0.05)。CC组妊娠6例,妊娠率为5.45%;LE组妊娠25例,妊娠率为27.78%;LE组妊娠率明显高于CC组,差异有统计学意义(P<0.05)。CC组治疗中卵巢过度刺激综合征(OHSS)发生2例,LE组发生1例,均为轻度;CC组临床妊娠中出现2例多胎,LE组出现1例多胎;两组OHSS发生率和多胎妊娠发生率比较差异无统计学意义(P>0.05)。结论于月经周期第3~7天服用LE,使胚胎着床情况更佳,妊娠率明显升高,值得在临床中加以推广应用。
Objective To compare the effect of clomiphene citrate (CC) and letrozole (LE) on ovulation induction in women with polycystic ovary syndrome (PCOS) and the outcome of pregnancy. Methods 200 patients with PCOS were randomly divided into LE group (90 cases) and CC group (110 cases). Both groups took LE and CC on days 3 to 7 of the menstrual cycle to observe the effects of LE and CC on follicular development, endometrium and pregnancy outcome. Results There were 79 cases (87.78%) of dominant follicles in LE group, 44 cases (40.00%) of CC group, the difference was statistically significant (P <0.05). There were 74 cases (93.67%) of single follicle development in LE group compared with 15 cases (34.09%) in CC group, the difference was statistically significant (P <0.05). The mean endometrial thickness of HCG on the day of HCG injection in the LE group was (8.28 ± 1.89) mm, which was significantly higher than that in the CC group (5.79 ± 1.49) mm, the difference was statistically significant (P <0.05). The pregnancy rate was 5.45% in the CC group and 25 cases in the LE group, the pregnancy rate was 27.78%. The pregnancy rate in the LE group was significantly higher than that in the CC group (P <0.05). There were 2 cases of OHSS in CC group and 1 case in LE group, 2 cases of multiple births in clinical pregnancy and 1 case of multiple births in LE group. The incidence of OHSS in both groups and The incidence of multiple pregnancy was no significant difference (P> 0.05). Conclusions LE was taken on the 3rd to 7th days of the menstrual cycle, which made the embryo implantation better and the pregnancy rate significantly increased, which deserved to be popularized in the clinic.