在接受 IVF 的卵巢反应不良者中，添加克罗米酚枸橼酸或来曲唑到促性腺激素治疗中是否能增加卵母细胞的产量？
Does the addition of clomiphene citrate or letrazole to gonadotropin treatment enhance the oocyte yield in poor responders undergoing IVF?
机构信息
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032, USA.
出版信息
J Assist Reprod Genet. 2011 Nov;28(11):1067-72. doi: 10.1007/s10815-011-9643-4. Epub 2011 Oct 12.
Abstract
PURPOSE
To evaluate the effect of adjunctive letrazole or clomiphene in IVF stimulation protocols.
METHODS
A retrospective analysis of high dose GnRH antagonist IVF cycles (450-600 IU of gonadotropins) that have met poor responder criteria. Selected consecutive cycles in same patients differed solely in presence or absence of adjunctive clomiphene or letrazole.
RESULTS
Supplementation with clomiphene citrate in poor responders showed significant improvements (p < 0.05) in estradiol levels (1506 vs. 1044 pg/ml), number of dominant follicles (5.6 vs. 3.9), oocytes retrieved (5.2 vs. 3.4) and number of transferred embryos (1.7 vs. 1.1). It significantly improved biochemical pregnancy rates (18.1% vs. 5.9%) while reducing cycle cancellations (11.7% vs. 32.6%). Letrozole supplementation showed similar effects.
CONCLUSION
Both Clomiphene and Letrazole performed similarly and showed significant effects. However, despite increasing oocyte yield and embryo transfer rates, the overall clinical and live birth rate in this population remained low and showed no measurable increase.
摘要
目的
评估辅助使用来曲唑或氯米酚对体外受精刺激方案的影响。
方法
对符合卵巢低反应标准的高剂量 GnRH 拮抗剂 IVF 周期（450-600IU 促性腺激素）进行回顾性分析。在相同患者的连续周期中，仅存在或不存在辅助氯米酚或来曲唑。
结果
在卵巢低反应患者中添加枸橼酸氯米酚可显著提高雌二醇水平（1506 与 1044pg/ml，p<0.05）、优势卵泡数（5.6 与 3.9）、获卵数（5.2 与 3.4）和移植胚胎数（1.7 与 1.1）。它还显著提高了生化妊娠率（18.1%与 5.9%），同时降低了周期取消率（11.7%与 32.6%）。来曲唑的补充也显示出类似的效果。
结论
氯米酚和来曲唑的效果相似，均有显著效果。然而，尽管增加了卵母细胞产量和胚胎移植率，但该人群的总体临床和活产率仍然较低，且没有明显增加。
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