PACMeR (PanHellenic Association for Continual Medical Research), Section of Obstetrics and Gynaecology and Public Health, Athens 10438, Greece.
Reprod Biomed Online. 2009 Oct;19(4):456-71. doi: 10.1016/j.rbmo.2009.06.008.
Ovulation induction remains a milestone in the treatment of women with anovulatory infertility. Clomiphene citrate (CC) is considered the first line treatment for induction of ovulation in women with polycystic ovary syndrome (PCOS), while it may be used for ovulation induction in unexplained infertility. Aromatase inhibitors (AI) have been introduced as a new treatment option that could challenge CC for ovulation induction. A systematic review of the literature was conducted in order to highlight the efficacy and safety of AI in female infertility. Current data from randomized and non-randomized trials suggest that AI may have a role in ovulation induction regimens in PCOS patients, as well as for ovarian stimulation, since they achieve comparable clinical pregnancy rates to CC. Furthermore, when combined with gonadotrophins, AI improve the ovarian response of poor responders and reduce the gonadotrophin dose required. However, the current review is based on small trials with a limited number of patients. If solid data from future large adequately powered randomized trials support current evidence regarding efficacy and safety, AI might offer a new treatment choice for infertile women.
促排卵仍然是治疗排卵障碍性不孕妇女的里程碑。枸橼酸氯米酚（CC）被认为是多囊卵巢综合征（PCOS）患者诱导排卵的一线治疗药物，也可用于不明原因不孕的排卵诱导。芳香化酶抑制剂（AI）已被引入作为一种新的治疗选择，可能会对 CC 诱导排卵构成挑战。进行了系统的文献回顾，以强调 AI 在女性不孕中的疗效和安全性。随机和非随机试验的现有数据表明，AI 可能在 PCOS 患者的排卵诱导方案中以及卵巢刺激中发挥作用，因为它们与 CC 相比可实现相当的临床妊娠率。此外，当与促性腺激素联合使用时，AI 可改善卵巢反应不良者的卵巢反应，并减少所需的促性腺激素剂量。然而，目前的综述基于患者数量有限的小型试验。如果未来的大型、充分有力的随机试验提供的数据支持当前关于疗效和安全性的证据，那么 AI 可能为不孕妇女提供一种新的治疗选择。
