在孕激素预处理的卵巢刺激方案下，与5天来曲唑给药相比，3天来曲唑给药可提高卵泡输出率。
The Follicular Output Rate was Improved with 3-Day Letrozole Administration Compared with 5-Day Letrozole Administration Under Progestin-Primed Ovarian Stimulation.
作者信息
Wang Xiaoning, Tian Jiarong, Tian Liu, Chen Xin, Zhang Zhenzhen, Diao Honglu, Zhang Ying
机构信息
Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, People's Republic of China.
Hubei Clinical Research Center for Reproductive Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, People's Republic of China.
出版信息
Drug Des Devel Ther. 2025 May 27;19:4397-4406. doi: 10.2147/DDDT.S521554. eCollection 2025.
PURPOSE
Progestin-primed ovarian stimulation (PPOS) has been widely employed in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. In recent years, letrozole (LE) combined with medroxyprogesterone acetate (MPA) has been used in this protocol to enhance ovarian response. This study compared the effects of a 5-day regimen with those of a 3-day regimen of letrozole within PPOS, focused on the follicular output rate (FORT) and blastocyst formation rates.
PATIENTS AND METHODS
From January 2017 to January 2020, 1,754 infertility patients who received PPOS protocol were divided into two groups: 577 patients received 2.5 mg/day LE for 5 days (LE 5-day), and 1177 patients received the same dose of LE for 3 days (LE 3-day). Propensity score matching (1:1) balanced confounders, yielding 489 patients per group. The primary outcoms was the FORT. The rate of blastocyst formation was evaluated as the secondary outcome. A multivariable logistic regression analysis was performed to compare the disparity in the FORT between the two groups.
RESULTS
After matching, the number of oocytes retrieved, number of mature oocytes, number of blastocysts, blastocyst formation rates, FORT, and clinical pregnancy rates were more favourable in the LE 3-day group than in the LE 5-day group (P < 0.05). In the multivariable linear regression model, after making adjustments for factors such as age, anti-Müllerian hormone (AMH), antral follicle count (AFC), body mass index (BMI), infertility type, and basal P, patients in the LE 3-day group exhibited an increase in the FOTR (β = 0.08, 95% confidence interval [CI] 0.02 to 0.14, P = 0.0082) and blastocyst formation rate (β = 0.23, 95% CI 0.17 to 0.29, P < 0.0001) compared to those in the LE 5-day group.
CONCLUSION
Compared with LE administration for 5 days, LE administration for 3 days may increase the FORT and the rate of blastocyst formation.
目的
孕激素预处理的卵巢刺激（PPOS）已广泛应用于体外受精/卵胞浆内单精子注射（IVF/ICSI）周期。近年来，来曲唑（LE）联合醋酸甲羟孕酮（MPA）已用于该方案以增强卵巢反应。本研究比较了PPOS方案中来曲唑5天方案与3天方案的效果，重点关注卵泡产出率（FORT）和囊胚形成率。
患者与方法
2017年1月至2020年1月，1754例接受PPOS方案的不孕患者被分为两组：577例患者接受2.5mg/天的LE治疗5天（LE 5天组），1177例患者接受相同剂量的LE治疗3天（LE 3天组）。倾向评分匹配（1:1）平衡了混杂因素，每组产生489例患者。主要结局是FORT。囊胚形成率作为次要结局进行评估。进行多变量逻辑回归分析以比较两组之间FORT的差异。
结果
匹配后，LE 3天组在获卵数、成熟卵母细胞数、囊胚数、囊胚形成率、FORT和临床妊娠率方面均优于LE 5天组（P<0.05）。在多变量线性回归模型中，在对年龄、抗苗勒管激素（AMH）、窦卵泡计数（AFC）、体重指数（BMI）、不孕类型和基础P等因素进行调整后，与LE 5天组相比，LE 3天组患者的FOTR增加（β=0.08，95%置信区间[CI]0.02至0.14，P=0.0082），囊胚形成率增加（β=0.23，95%CI 0.17至0.29，P<0.0001）。
结论
与来曲唑给药5天相比，来曲唑给药3天可能会增加FORT和囊胚形成率。
Zotero 插件