Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Beijing, China.
BMC Endocr Disord. 2023 Apr 25;23(1):90. doi: 10.1186/s12902-023-01336-z.
This study aimed to evaluate the predictive value of the initial screening characteristics of women with anovulatory polycystic ovary syndrome (PCOS) who did or did not respond to 2.5 mg letrozole (LET).
The clinical and laboratory characteristics of women with PCOS who underwent LET treatment were evaluated. Women with PCOS were stratified according to their responses to LET (2.5 mg). The potential predictors of their responses to LET were estimated using logistic regression analysis.
Our retrospective study included 214 eligible patients with a response to 2.5 mg LET (n = 131) or no response to 2.5 mg LET (n = 83). PCOS patients who responded to 2.5 mg LET showed better outcomes than those who did not (2.5 mg LET) for pregnancy rate, live birth rate, pregnancy rate per patient, and live birth rate per patient. Logistic regression analyses showed that late menarche (odds ratio [OR], 1.79 [95% confidence intervals (CI), 1.22-2.64], P = 0.003), and increased anti-müllerian hormone (AMH) (OR, 1.12 [95% CI, 1.02-1.23], P = 0.02), baseline luteinizing hormone (LH)/ follicle stimulating hormone (FSH) (OR, 3.73 [95% CI, 2.12-6.64], P < 0.001), and free androgen index (FAI) (OR, 1.37 [95% CI, 1.16-1.64], P < 0.001) were associated with a higher possibility of no response to 2.5 mg LET.
PCOS patients with an increased LH/FSH ratio, AMH, FAI, and late menarche may need an increased dosage of LET for a treatment response, which could be helpful in designing a personalized treatment strategy.
本研究旨在评估对服用 2.5mg 来曲唑（LET）有反应和无反应的排卵障碍型多囊卵巢综合征（PCOS）女性的初始筛选特征，以评估其预测价值。
评估了接受 LET 治疗的 PCOS 女性的临床和实验室特征。根据对 LET（2.5mg）的反应对 PCOS 女性进行分层。使用逻辑回归分析估计她们对 LET 反应的潜在预测因素。
我们的回顾性研究纳入了 214 名对 2.5mg LET 有反应的合格患者（n=131）或对 2.5mg LET 无反应的患者（n=83）。与无反应的患者相比，对 2.5mg LET 有反应的 PCOS 患者的妊娠率、活产率、每位患者的妊娠率和每位患者的活产率更好。逻辑回归分析显示，晚初潮（优势比 [OR]，1.79 [95%置信区间 (CI)，1.22-2.64]，P=0.003）和抗苗勒管激素（AMH）增加（OR，1.12 [95% CI，1.02-1.23]，P=0.02）、基础黄体生成素（LH）/卵泡刺激素（FSH）比值（OR，3.73 [95% CI，2.12-6.64]，P<0.001）和游离雄激素指数（FAI）（OR，1.37 [95% CI，1.16-1.64]，P<0.001）与对 2.5mg LET 无反应的可能性更高相关。
LH/FSH 比值、AMH、FAI 和晚初潮增加的 PCOS 患者可能需要增加 LET 的剂量以获得治疗反应，这有助于制定个性化的治疗策略。
