Pourali Leila, Ayati Sedigheh, Tavakolizadeh Shirin, Soleimani Hourieh, Teimouri Sani Fatemeh
Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mashhad University of Medical Sciences, Mashhad, Iran.
Int J Reprod Biomed. 2017 Jan;15(1):49-54.
Clomiphene citrate is one of the effective drugs for infertility treatment due to oligo-ovulation or anovulation. Intrauterine insemination (IUI) is one of more adherent methods for treatment of infertile cases which is followed by controlled ovarian hyperstimulation (COH).
the aim of this study was to evaluate Clomiphene citrate versus letrozole with gonadotropins in IUI cycles.
In this prospective randomized trial, 180 infertile women who were referred to Milad Hospital were selected. The first group received 5 mg/day letrozole on day 3-7 of menstrual cycle. The second group received 100 mg/day Clomiphene in the same way as letrozole. In both groups, human menopausal gonadotropin was administered every day starting on day between 6-8 of cycle. Ovulation was triggered with urinary Human Chorionic Gonadotropin (5000 IU) when have two follicles of ≥16 mm. IUI was performed 36 hr later.
The number of matured follicles, cycle cancellation, and abortion were the same in both groups. Endometrial thickness was higher at the time of human menopausal gonadotropin administration in letrozole group. Chemical and clinical pregnancy rates were much higher in letrozole group. Ovarian hyperstimulation was significantly higher in clomiphene group.
Letrozole appears to be a good alternative to clomiphene citrate with fewer side effects.
枸橼酸氯米芬是治疗因排卵稀少或无排卵导致的不孕症的有效药物之一。宫腔内人工授精（IUI）是治疗不孕症更常用的方法之一，通常在控制性卵巢过度刺激（COH）后进行。
本研究旨在评估枸橼酸氯米芬与来曲唑联合促性腺激素在IUI周期中的效果。
在这项前瞻性随机试验中，选取了180名转诊至米拉德医院的不孕女性。第一组在月经周期的第3 - 7天每天服用5mg来曲唑。第二组以与来曲唑相同的方式每天服用100mg枸橼酸氯米芬。两组均从周期的第6 - 8天开始每天注射人绝经期促性腺激素。当有两个卵泡直径≥16mm时，用尿人绒毛膜促性腺激素（5000IU）触发排卵。36小时后进行IUI。
两组的成熟卵泡数量、周期取消率和流产率相同。来曲唑组在注射人绝经期促性腺激素时子宫内膜厚度更高。来曲唑组的化学妊娠率和临床妊娠率更高。枸橼酸氯米芬组的卵巢过度刺激发生率显著更高。
来曲唑似乎是枸橼酸氯米芬的良好替代药物，副作用更少。
