Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Gynecol Endocrinol. 2020 Mar;36(3):257-260. doi: 10.1080/09513590.2019.1650338. Epub 2019 Aug 7.
This study aimed to analyze the effects of a new protocol with letrozole on the outcomes of fertilization (IVF) cycles in women with endometriosis. This retrospective cohort study was conducted for women diagnosed with endometriosis undergoing IVF from an infertility clinic. A new protocol, combination therapy with letrozole and gonadotropin, was used from August 2016 to January 2018 ('protocol 1', = 38). From March 2014 to July 2016, conventional IVF with gonadotropin was administered ('protocol 2', = 26). Age and ovarian reserve were comparable between the two groups. The patients who received protocol 1 resulted in a significantly lower peak estradiol level in IVF compared with those received protocol 2 (722 ± 1076 pg/mL versus 2168 ± 1521 pg/mL, < .001). The length of stimulation, the total dose of gonadotropin, number of oocytes retrieved, fertilization rates, and number of embryos obtained were similar between the two groups. The mean percentage of mature oocytes was lower (69.9 ± 23.7% versus 80.2 ± 21.0%, = .029) in patients with protocol 1. While maintaining low estrogen levels, the combination therapy with letrozole and gonadotropin produce similar oocyte and embryo yield to the conventional IVF protocol in women with endometriosis.
本研究旨在分析在子宫内膜异位症患者的体外受精（IVF）周期中使用来曲唑新方案对结局的影响。这是一项回顾性队列研究，纳入了在不孕不育诊所接受 IVF 的子宫内膜异位症患者。自 2016 年 8 月至 2018 年 1 月，采用来曲唑和促性腺激素联合治疗的新方案（方案 1，=38）。2014 年 3 月至 2016 年 7 月，采用常规促性腺激素 IVF（方案 2，=26）。两组患者的年龄和卵巢储备情况相当。与方案 2 相比，方案 1 患者的 IVF 中峰值雌二醇水平显著降低（722±1076 pg/mL 比 2168±1521 pg/mL，<.001）。两组的刺激时间、促性腺激素总剂量、获卵数、受精率和胚胎数相似。方案 1 患者的成熟卵母细胞比例较低（69.9±23.7%比 80.2±21.0%，=0.029）。来曲唑联合促性腺激素的联合治疗在维持低雌激素水平的同时，在子宫内膜异位症患者中产生的卵母细胞和胚胎数量与常规 IVF 方案相似。
