Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
Fertil Steril. 2011 Oct;96(4):1051-6. doi: 10.1016/j.fertnstert.2011.07.1092.
To compare the effect of clomiphene citrate (CC) and letrozole on endometrial receptivity in women with polycystic ovary syndrome (PCOS).
A randomized controlled trial.
University teaching hospital.
PATIENT(S): Ten anovulatory women with PCOS and 5 fertile ovulatory women.
INTERVENTION(S): Patients received 2.5 mg of letrozole on cycle days 3-7 (5 patients, 1 cycle) or 50 mg of CC on cycle days 5-9 (5 patients, 1 cycle).
MAIN OUTCOME MEASURE(S): Serum estrogen (E) and progesterone (P) endometrial protein and messenger RNA (mRNA) expression of leukemia inhibitory factor (LIF), dickkhopf homolog 1 (DKK-1), fibroblast growth factor 22 (FGF-22), and endometrial mRNA expression of LIF/GP130 receptor (LIFR).
RESULT(S): No statistically significant differences were observed between groups compared with fertile ovulatory women when serum E and P were examined, or between body mass index (BMI), and cycle day at time of biopsy. Letrozole increased mRNA expression of LIF, DKK1, LIFR, and FGF-22, whereas CC only increased endometrial mRNA expression of LIF. Letrozole mRNA expression directly translated into increased protein expression of like genes in the endometrium. The CC protein expression of DKK-1 was significantly decreased compared with controls.
CONCLUSION(S): Letrozole positively influences a number of markers of endometrial receptivity compared with CC.
比较枸橼酸氯米酚（CC）和来曲唑对多囊卵巢综合征（PCOS）患者子宫内膜容受性的影响。
随机对照试验。
大学教学医院。
10 名排卵障碍的 PCOS 患者和 5 名有生育能力的排卵患者。
患者在周期第 3-7 天接受 2.5 毫克来曲唑（5 例，1 个周期）或在周期第 5-9 天接受 50 毫克 CC（5 例，1 个周期）。
血清雌激素（E）和孕激素（P）、白血病抑制因子（LIF）、Dickkopf 同源物 1（DKK-1）、成纤维细胞生长因子 22（FGF-22）的蛋白和信使 RNA（mRNA）表达，以及 LIF/GP130 受体（LIFR）的子宫内膜 mRNA 表达。
与有生育能力的排卵患者相比，血清 E 和 P 检查时，两组间无统计学差异，体重指数（BMI）和活检时的周期天数也无统计学差异。来曲唑增加了 LIF、DKK1、LIFR 和 FGF-22 的 mRNA 表达，而 CC 仅增加了子宫内膜中 LIF 的 mRNA 表达。来曲唑的 mRNA 表达直接转化为子宫内膜中这些基因蛋白表达的增加。与对照组相比，CC 的 DKK-1 蛋白表达显著降低。
与 CC 相比，来曲唑对多种子宫内膜容受性标志物有积极影响。
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