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比较两种不同起始剂量的重组卵泡刺激素(rFSH)在非肥胖多囊卵巢综合征(PCOS)妇女宫腔内人工授精(IUI)周期中的应用:一项回顾性队列研究。

Comparison of two different starting doses of recombinant follicle stimulating hormone (rFSH) for intrauterine insemination (IUI) cycles in non-obese women with polycystic ovary syndrome (PCOS): a retrospective cohort study.

机构信息

Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health Education and Research Hospital, University of Health Sciences, Ankara, Turkey.

出版信息

J Obstet Gynaecol. 2021 Nov;41(8):1234-1239. doi: 10.1080/01443615.2020.1849069. Epub 2021 Feb 24.

Abstract

We aimed to compare the efficacy of two different starting doses of recombinant follicle stimulating hormone (rFSH), 37.5 vs. 75 international units (IU) for intrauterine insemination (IUI) cycles in non-obese women with polycystic ovary syndrome (PCOS). A total of 109 women who underwent first rFSH stimulated IUI cycle were included in this retrospective cohort study. The primary outcome measure was the clinical pregnancy rate. No significant difference was found in terms of clinical pregnancy rate between the two groups (22% for the 37.5-IU group and 24% for the 75-IU group, respectively,  = .808). There was no significant difference in monofollicular development rate among the groups ( = .354). The total rFSH consumption was lower in the 37.5-IU group compared to the 75-IU group (< .001). There was no statistically significant difference in pregnancy rates between the 37.5-IU and 75-IU groups in both normal weight (BMI: 19-24.9 kg/m) and overweight (BMI: 25-29.9 kg/m) women ( = .889 and .518, respectively). These results suggest that the starting doses of 37.5 and 75 IU of rFSH do not show significant difference in clinical pregnancy rates in non-obese PCOS women undergoing IUI cycles.Impact Statement Low-dose gonadotropin treatment is advised for women with polycystic ovary syndrome (PCOS). However, there are few comparative data on the efficacy of different starting doses of recombinant follicle stimulating hormone (rFSH) for intrauterine insemination (IUI) cycles in PCOS women. There was no statistically significant difference in pregnancy rates of non-obese patients with PCOS having IUI whether rFSH was started at 37.5 or 75 international units (IU). A starting dose of 37.5 IU of rFSH may be a reasonable approach for IUI cycles in non-obese PCOS women.

摘要

我们旨在比较两种不同起始剂量的重组卵泡刺激素(rFSH),即 37.5 国际单位(IU)和 75 IU,用于非肥胖多囊卵巢综合征(PCOS)妇女的宫腔内人工授精(IUI)周期。共有 109 名接受首次 rFSH 刺激 IUI 周期的妇女纳入本回顾性队列研究。主要结局指标是临床妊娠率。两组之间的临床妊娠率无显著差异(37.5-IU 组为 22%,75-IU 组为 24%, = .808)。两组之间单卵泡发育率无显著差异( = .354)。与 75 IU 组相比,37.5 IU 组的总 rFSH 用量较低(<0.001)。在正常体重(BMI:19-24.9 kg/m)和超重(BMI:25-29.9 kg/m)的妇女中,37.5 IU 组和 75 IU 组的妊娠率均无统计学差异( = .889 和.518)。这些结果表明,在接受 IUI 周期的非肥胖 PCOS 妇女中,起始剂量为 37.5 和 75 IU 的 rFSH 在临床妊娠率方面没有显著差异。

结论

对于多囊卵巢综合征(PCOS)妇女,建议使用低剂量促性腺激素治疗。然而,对于 PCOS 妇女的 IUI 周期中不同起始剂量的重组卵泡刺激素(rFSH)的疗效比较数据较少。在接受 IUI 的非肥胖 PCOS 患者中,rFSH 起始剂量为 37.5 或 75 IU 时,妊娠率无统计学差异。对于非肥胖 PCOS 妇女的 IUI 周期,起始剂量为 37.5 IU 的 rFSH 可能是一种合理的方法。

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