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来曲唑联合小剂量肌内注射人绝经期促性腺激素对156例多囊卵巢综合征患者排卵及妊娠的影响

Effects of letrozole in combination with low-dose intramuscular injection of human menopausal gonadotropin on ovulation and pregnancy of 156 patients with polycystic ovary syndrome.

作者信息

Chen Zhihua, Zhang Mengzhen, Qiao Yuhuan, Yang Junjuan

机构信息

Zhihua Chen, Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, P. R. China.

Mengzhen Zhang, Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, P. R. China.

出版信息

Pak J Med Sci. 2016 Nov-Dec;32(6):1434-1438. doi: 10.12669/pjms.326.11391.

Abstract

OBJECTIVE

To explore the effects of letrozole (LE) in combination with low-dose intramuscular injection of human menopausal gonadotropin (HMG) on the ovulation induction and pregnancy of patients with polycystic ovary syndrome (PCOS).

METHODS

A total of 156 patients with PCOS infertility were randomly divided into an LE group, a clomiphene citrate (CC) group and an LE + HMG group (n= 52). LE and CC were orally taken according to the prescribed dosage on the 3rd-5th days of menstruation respectively, and 75 IU HMG was given through intramuscular injection. The ovulation induction parameters and pregnancy outcomes were observed.

RESULTS

The number of ovulation cycle of LE + HMG group was significantly higher than that of LE group (χ=8.451, P<0.001). After injection of human chorionic gonadotropin, both endometrial thickness and number of mature follicles of LE + HMG group were significantly higher than those of other two groups (P<0.001), and the daily estradiol (E2) level was also higher (q=4.531, P<0.05). The pregnancy rate of LE + HMG group was 55.7%, which exceeded those of other two groups (compared to LE group, χ=4.012, P<0.05). In LE + HMG group, the average medication cycle of clinically pregnant patients was (2.9 ± 0.3) weeks, which was significantly shorter than those of CC and LE groups (F=17.241, P<0.001).

CONCLUSION

The regimen using LE in combination with low-dose intramuscular injection of HMG has satisfactory therapeutic effects on ovulation induction, short medication cycle and high clinical pregnancy rate, which is promising for treating patients with PCOS infertility.

摘要

目的

探讨来曲唑(LE)联合小剂量肌内注射人绝经期促性腺激素(HMG)对多囊卵巢综合征(PCOS)患者促排卵及妊娠的影响。

方法

将156例PCOS不孕患者随机分为LE组、枸橼酸氯米芬(CC)组和LE + HMG组(n = 52)。LE和CC分别在月经第3 - 5天按规定剂量口服,肌内注射75 IU HMG。观察促排卵参数及妊娠结局。

结果

LE + HMG组排卵周期数显著高于LE组(χ = 8.451,P < 0.001)。注射人绒毛膜促性腺激素后,LE + HMG组的子宫内膜厚度和成熟卵泡数均显著高于其他两组(P < 0.001),且每日雌二醇(E2)水平也更高(q = 4.531,P < 0.05)。LE + HMG组妊娠率为55.7%,超过其他两组(与LE组比较,χ = 4.012,P < 0.05)。LE + HMG组临床妊娠患者的平均用药周期为(2.9 ± 0.3)周,显著短于CC组和LE组(F = 17.241,P < 0.001)。

结论

LE联合小剂量肌内注射HMG方案在促排卵、缩短用药周期及提高临床妊娠率方面疗效满意,对治疗PCOS不孕患者具有良好前景。

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