Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Gynecol Endocrinol. 2012 Feb;28(2):87-90. doi: 10.3109/09513590.2011.589924. Epub 2011 Jul 20.
To compare the efficacy of minimal stimulation and clomiphene citrate (CC) as a first-line treatment for anovulatory infertility associated with polycystic ovary syndrome (PCOS).
One hundred and thirteen women with PCOS were selected in this randomized controlled trial. Patients received minimal stimulation protocol consisted of 5 days CC (100 mg/day) then 150 IU of highly purified uFSH on cycle day 9 (n = 58, 159 cycles) or CC only (n = 55, 153 cycles) for up to three cycles. Outcome measures were: clinical pregnancy rate per cycle, number of growing and mature follicles, serum E2, endometrial thickness at the hCG day, serum P, ovulation and miscarriage rates.
There were no differences between both groups regarding the clinical pregnancy rate per cycle and per woman (8.8% vs. 7.8 % and 24.1% vs. 21.8%; p = 0.23, p = 0.36, respectively). One twin pregnancy occurred in each group. Miscarriage rate was comparable (14.3% vs. 16.7%; p = 0.38). No differences were found regarding the number of follicles, serum P, ovulation rate, E2 and endometrial thickness at the hCG day (7.8 ± 0.5 vs. 7.6 ± 0.6 mm; p = 0.52).
Ovulation induction with minimal stimulation is not more effective than CC alone for achieving pregnancy when used as initial treatment in PCOS patients.
比较微刺激方案与枸橼酸氯米酚（CC）作为一线治疗多囊卵巢综合征（PCOS）相关排卵障碍的疗效。
本随机对照试验纳入了 113 名 PCOS 患者。患者接受微刺激方案治疗，包括 CC 治疗 5 天（100 mg/天），然后在周期第 9 天给予 150 IU 高纯尿促卵泡素（n = 58，159 个周期）或仅 CC 治疗（n = 55，153 个周期），最多治疗三个周期。观察指标包括：每个周期的临床妊娠率、生长卵泡和成熟卵泡数量、血清 E2、HCG 日子宫内膜厚度、血清 P、排卵率和流产率。
两组患者每个周期和每个患者的临床妊娠率（8.8% vs. 7.8%和 24.1% vs. 21.8%；p = 0.23，p = 0.36）和流产率（14.3% vs. 16.7%；p = 0.38）均无差异。两组各有一例双胞胎妊娠。两组的卵泡数量、血清 P、排卵率、E2 和 HCG 日子宫内膜厚度均无差异（7.8 ± 0.5 vs. 7.6 ± 0.6 mm；p = 0.52）。
与单独使用 CC 相比，作为 PCOS 患者的初始治疗，微刺激方案诱导排卵并不能提高妊娠率。
