Akgul Ozlem Karabay, Guraslan Hakan
Department of Obstetrics and Gynaecology, University of Health Sciences Istanbul Bagcilar Research and Training Hospital, <br> Istanbul, Turkey.
J Coll Physicians Surg Pak. 2023 Feb;33(2):217-221. doi: 10.29271/jcpsp.2023.02.217.
To compare the clinical, metabolic, and hormonal characteristics of patients with and without selected dominant follicles in infertile women with PCOS who used letrozole for ovulation induction.
A descriptive cohort study.
Department of Obstetrics and Gynaecology of Bagcilar Research and Training Hospital, Istanbul, Turkey, from October 2019 to November 2021.
Eighty-eight female patients with PCOS, who underwent ovulation induction by giving 5 mg/day letrozole, were screened for demographic characteristics, laboratory values, and dominant follicle development. Those who were given letrozole as the first treatment agent, those who took clomiphene citrate (CC) and started letrozole the following month, and those who were treated with letrozole and given letrozole again were recorded separately. Seventy-five patients responded to letrozole and developed a dominant follicle; 13 patients did not develop a dominant follicle. Threshold values were determined for statistically significant parameters between patients with and without dominant follicles.
Follicle development occurred in 85.2% of the women. A statistically significant variable in clinical and metabolic values, between ovulating and non-ovulating groups could not be found. There was a significant difference between the two groups for the serum AMH value, total testosterone value, and FSH level. The authors found that follicle response was higher in those with AMH values less than 11.89 ng/mL, FSH levels higher than 6.25 Iu/L, and total testosterone less than 0.96 ng/mL. In this study, the pregnancy rate was found to be lower than in the literature (11%).
Among the women with PCOS who had ovulation induction with letrozole, follicle development was higher in women with lower FSH, androgen and AMH values.
Letrozole, Aromatase inhibitor, Androgens, Ovulation induction, AMH.
比较多囊卵巢综合征(PCOS)不孕女性中使用来曲唑进行促排卵时,有或无选定优势卵泡患者的临床、代谢及激素特征。
描述性队列研究。
土耳其伊斯坦布尔巴伊西拉尔研究与培训医院妇产科,2019年10月至2021年11月。
对88例接受每日5mg来曲唑促排卵的PCOS女性患者进行人口统计学特征、实验室检查值及优势卵泡发育情况筛查。分别记录那些将来曲唑作为首个治疗药物的患者、服用枸橼酸氯米芬(CC)且次月开始用来曲唑的患者,以及接受来曲唑治疗后再次使用来曲唑的患者。75例患者对来曲唑有反应并发育出优势卵泡;13例患者未发育出优势卵泡。确定有或无优势卵泡患者之间具有统计学意义的参数阈值。
85.2%的女性出现卵泡发育。在排卵组和未排卵组之间未发现临床和代谢值方面具有统计学意义的变量。两组在血清抗苗勒管激素(AMH)值、总睾酮值和促卵泡生成素(FSH)水平上存在显著差异。作者发现,AMH值低于11.89ng/mL、FSH水平高于6.25IU/L且总睾酮低于0.96ng/mL的患者卵泡反应更高。在本研究中,妊娠率低于文献报道(11%)。
在使用来曲唑进行促排卵的PCOS女性中,FSH、雄激素和AMH值较低的女性卵泡发育情况更好。
来曲唑;芳香化酶抑制剂;雄激素;促排卵;AMH