Sakar Mehmet Nafi, Oglak Suleyman Cemil
Mehmet Nafi Sakar, Department of Obstetrics and Gynecology, Memorial Diyarbakir Hospital, Diyarbakır, Turkey.
Suleyman Cemil Oglak, Department of Obstetrics and Gynecology, University of Health Sciences, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey.
Pak J Med Sci. 2020 Nov-Dec;36(7):1460-1465. doi: 10.12669/pjms.36.7.3345.
This study was aimed to compare the clinical outcomes of ovulation induction (OI) by timed intercourse with letrozole (LTZ) and clomiphene citrate (CC).
Three hundred and twenty-three patients with polycystic ovary syndrome (PCOS) who underwent OI with LTZ or CC between February 2017 and November 2018 were included in this retrospective study. The patients were divided into two groups as the CC group (n=148) and the LTZ group (n=175). Endometrial thickness, follicular development, ovulation, clinical pregnancy, abortion, and live birth rates of the groups were analyzed.
The mean endometrium thickness of the CC group was 7.1±1.7 mm, and the LTZ group was 8.6±1.8 mm (p<0.001). The ovulation rate per cycle was higher in the LTZ group (93.1%) in comparison with the CC group (83.8%) (p=0.013). Clinical pregnancy rates were 52% in the LTZ group, and 41.2% in the CC group (p=0.047). LTZ with 44% of live birth rate was superior to CC with a 33% live birth rate (p=0.029).
LTZ is an effective OI agent in PCOS patients. LTZ is superior to CC in terms of pregnancy rates and live birth rates. As a result, we recommend that LTZ should be the first-line treatment agent in patients with PCOS.
本研究旨在比较来曲唑（LTZ）与枸橼酸氯米芬（CC）定时性交诱导排卵（OI）的临床效果。
本回顾性研究纳入了2017年2月至2018年11月期间接受LTZ或CC进行OI的323例多囊卵巢综合征（PCOS）患者。患者分为两组，即CC组（n = 148）和LTZ组（n = 175）。分析两组的子宫内膜厚度、卵泡发育、排卵、临床妊娠、流产和活产率。
CC组的平均子宫内膜厚度为7.1±1.7mm，LTZ组为8.6±1.8mm（p<0.001）。与CC组（83.8%）相比，LTZ组的每个周期排卵率更高（93.1%）（p = 0.013）。LTZ组的临床妊娠率为52%，CC组为41.2%（p = 0.047）。活产率方面，LTZ组为44%，优于CC组的33%（p = 0.029）。
LTZ是PCOS患者有效的OI药物。在妊娠率和活产率方面，LTZ优于CC。因此，我们建议LTZ应作为PCOS患者的一线治疗药物。
