【摘要】 目的观察来曲唑(促排卵药)对耐枸橼酸氯米芬的多囊卵巢综合征(P-COS)患者的临床疗效。方法选择耐枸橼酸氯米芬的PCOS患者36例,随机分为实验组和对照组,每组各18例。于月经来潮或撤退性出血的第3～7天,实验组口服来曲唑2.5mg;对照组用低剂量递增法肌注尿促性素(HMG),记录卵泡发育、子宫内膜厚度,并在肌注绒毛膜促性腺激素(HCG)日,取静脉血测定雌激素(E2)水平。结果来曲唑不仅可提高患者对促排卵药HCG的敏感性,同时单卵泡的发生率明显高于对照组;且其对子宫内膜的发育无不良影响,血清E2浓度明显低于对照组。来曲唑未诱导卵巢过度刺激综合征(OHSS)。结论来曲唑用于耐枸橼酸氯米芬抵抗的PCOS患者具有良好的排卵率和妊娠率,且无OHSS风险。更多还原

【Abstract】 Objective To investigate the effectiveness of letrozole (LE) as ovulation induction agent in patients with polycystic ovarian syndrome (PCOS) who were resistant to clomiphene citrate (CC). Methods Thirty six CC-resistant PCOS patients were recruited and randomly divided into two groups:trial and control groups (18 cases,respectively). Either oral administration of LE (2.5 mg,total 30 cycles) or injections of menotrophin (hMG,im 75~112.5 u·d-1,total 33 cycles) by step-up method.For each patient started on the 1st day of her menstrual cycle or day 3~7 post withdrawal bleeding. Follicular development,endometrial thickness and E2 level at chorionic gonadotropin(hCG) injection were determined. Results LE can increase sensitivity to hCG-induced ovulation. Monofollicular development rate in trial group was significantly higher than the control group,while pre-ovulatory E2 levels was much lower than the control group. Abnormal endometrial differentiation and/or development of an ovarian hyper stimulation syndrome (OHSS) were not observed in trial group. Conclusion LE is effective in ovulation induction,and thus,increases pregnancy rate in CC-resistant PCOS without the risk of developing OHSS.更多还原