来曲唑用于有排卵不孕症妇女的促排卵效果观察——与氯米芬的对照研究

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目的探讨来曲唑用于有排卵不孕症妇女的促排卵效果及其对生殖激素的影响。方法选择2005-06-01-2005-10-31北京大学第三医院拟行宫腔内人工授精(IUI),或指导同房,或供精人工授精(AID)的111例有排卵的不孕症妇女,于月经周期第3~7天,每日口服来曲唑2·5mg(68例),或于月经周期第5~9天每日口服氯米芬(clomifene)50mg(43例)。超声监测卵泡发育,并于月经周期第8天和HCG日取静脉血测定黄体生成素(LH)、雌二醇(E2)、睾酮(T)和雄烯二酮(A)。当最大卵泡的平均直径≥20mm时,肌注HCG10000IU诱发排卵。观察排卵率、妊娠率、子宫内膜厚度及生殖激素的变化。结果来曲唑组的排卵率和周期妊娠率与氯米芬组相似(P>0·05),其优势卵泡数以及成熟卵泡数均显著低于氯米芬组(P<0·01)。来曲唑组在HCG日子宫内膜的厚度显著厚于氯米芬组(P<0·01)。其在月经周期第8天和HCG日血清E2水平均显著低于氯米芬组(P<0·01),月经周期第8天血清A显著高于氯米芬组(P<0·05),这种差异在HCG日消失,但血清T水平在两组之间没有差异。来曲唑组在HCG日血清LH水平明显高于氯米芬组。结论来曲唑用于有排卵的不孕症妇女,具有良好的排卵率,但其排卵率和妊娠率并未优于氯米芬,其能否作为一线的促排卵药物还需要进一步的研究结果来支持。 Objective To investigate the effect of letrozole on ovulation induction in ovulation infertile women and its effects on reproductive hormones. Methods of choice 2005-06-01-2005-10-31 Third Hospital of Peking University to be performed intrauterine insemination (IUI), or to guide the same room, or for artificial insemination (AID) of 111 cases of ovulation infertility women , Letrozole 2.5 mg (68) orally daily on the 3rd to 7th day of the menstrual cycle or 50 mg (43) of clomifene daily on the 5th to 9th day of the menstrual cycle. Ovarian follicle development was monitored by ultrasound. Luteinizing hormone (LH), estradiol (E2), testosterone (T) and androstenedione (A) were determined on the 8th day of the menstrual cycle and venous blood on HCG day. When the average diameter of the largest follicles ≥ 20mm, intramuscular HCG10000IU induced ovulation. Observe ovulation rate, pregnancy rate, endometrial thickness and reproductive hormone changes. Results The levofloxacin and cycle pregnancy rates in letrozole group were similar to those in clomiphene citrate group (P> 0.05). The number of dominant follicles and the number of mature follicles in letrozole group were significantly lower than those in clomiphene citrate group (P <0.01). Letrozole group had significantly thicker endometrium at HCG day than clomiphene group (P <0.01). Serum A was significantly lower than that of clomiphene (P <0.05) on the 8th day of the menstrual cycle in the 8th day of the menstrual cycle and on the HCG day, , This difference disappeared on HCG day, but serum T level did not differ between the two groups. The level of LH in letrozole group on HCG day was significantly higher than that in clomiphene group. Conclusion Letrozole is used in ovulation infertile women with good ovulation rate, but its ovulation rate and pregnancy rate are not superior to clomiphene, and its further application as a first-line ovulation promoting drug is needed To support.
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