Department of Gynaecology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China.
Reprod Biomed Online. 2011 Jul;23(1):91-6. doi: 10.1016/j.rbmo.2011.03.024. Epub 2011 Apr 3.
The aim of this study was to systematically compare the clinical efficacy and safety of letrozole with clomiphene citrate for ovulation induction in women with polycystic ovary syndrome (PCOS). The Cochrane Central Register of Controlled Trials, PubMed, EMbase, CBMdisc and CNKI were searched for eligible randomized controlled trials (RCT) comparing letrozole with clomiphene citrate in PCOS patients. Two reviewers independently extracted information and evaluated methodological quality according to the Cochrane Handbook 5.0. Meta-analysis was performed with the fixed-effects model or random-effects model according to the heterogeneity. Six eligible RCT involving 841 patients were included. Letrozole was associated with a number of lower mature follicles per cycle (standardized mean difference (SMD) -1.41; 95% confidence intervales (CI) -1.54 to -1.28; P<0.00001) compared with clomiphene citrate. There were no significant differences in pregnancy rate (relative risk (RR) 0.97; 95% CI 0.79 to 1.18), abortion rate (RR 1.38; 95% CI 0.48 to -3.96) and multiple pregnancy rate (RR 0.34; 95% CI 0.07 to -1.72) between the two groups. The evidence from ovulation rates was not enough to support either letrozole or clomiphene citrate. In conclusion, letrozole is as effective as clomiphene citrate for ovulation induction in patients with PCOS.
本研究旨在系统比较来曲唑与枸橼酸氯米酚在多囊卵巢综合征（PCOS）患者促排卵中的临床疗效和安全性。检索 Cochrane 中央对照试验注册库、PubMed、EMbase、CBMdisc 和 CNKI 中比较来曲唑与枸橼酸氯米酚治疗 PCOS 患者的随机对照试验（RCT）。两名评审员独立提取信息并根据 Cochrane 手册 5.0 评价方法学质量。根据异质性采用固定效应模型或随机效应模型进行荟萃分析。纳入 6 项符合条件的 RCT，共 841 例患者。与枸橼酸氯米酚相比，来曲唑每个周期的成熟卵泡数较少（标准化均数差（SMD）-1.41；95%置信区间（CI）-1.54 至-1.28；P<0.00001）。两组间妊娠率（相对风险（RR）0.97；95%CI 0.79 至 1.18）、流产率（RR 1.38；95%CI 0.48 至-3.96）和多胎妊娠率（RR 0.34；95%CI 0.07 至-1.72）均无显著差异。排卵率的证据不足以支持来曲唑或枸橼酸氯米酚。总之，来曲唑与枸橼酸氯米酚在诱导 PCOS 患者排卵方面同样有效。
