两种促排卵方案在多囊卵巢综合征不孕患者中.doc

两种促排卵方案在多囊卵巢综合征不孕患者中[摘要] 目的：比较两种促排卵方案用于多囊卵巢综合征（PCOS）不孕患者的促排卵及妊娠结局，旨在寻找一种新的促排卵药物。方法：拟行促排卵治疗的PCOS患者86例，随机分为来曲唑（LE）组（40例）和克罗米芬（CC）组（46例）。LE组从月经第3～7天给予LE 5 mg/d口服，第7天加用促性腺激素（HMG）至HCG日；CC组从月经第5～9天给予CC 100 mg/d口服，第6天加用HMG至HCG日。于HCG日观察≥14 mm卵泡数、≥16 mm卵泡数、子宫内膜厚度及形态，记录妊娠率、流产例数、异位妊娠例数和卵巢过度刺激综合征（OHSS）发生例数。结果：LE组HCG注射日子宫内膜厚度明显高于CC组，两组比较，有显著性差异（P＜0.01），LE组HCG注射日≥14 mm卵泡数明显减少，两组比较，有显著性差异（P＜0.01），且无一例发生OHSS。LE组妊娠率和继续妊娠率都高于CC组，但差异无统计学意义。结论：LE有类似CC的促排卵作用及相似的妊娠率。 [关键词] 来曲唑；克罗米芬；多囊卵巢综合征；促排卵 [中图分类号] R588.6[文献标识码]A [文章编号]1673-7210（2009）06（c）-009-03 Clinical observation of infertility patients for two ovulation induction in women with polycystic ovarian syndrome HUANG Xuehui, LIAO Yi, MA Fang (Department of Gynecology and Obstetrics, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China) [Abstract] Objective: To search for a new drug for ovulation induction through a comparison of the effects and pregnancy outcome of two ovulation induction in women with polycystic ovarian syndrome (PCOS). Methods: 86 cases of patients with PCOS undergoing ovarian stimulation were randomly divided into Letrozole (LE) group (40 cases) and Clomiphene Critate (CC) group (46 cases). Subjects in LE group received LE with a dosage of 5 mg/d from the 3rd day to the 7th day of menstruation, and received HMG injection from the 7th day to HCG day. Subjects in CC group received CC with a dosage of 100 mg/d from the 5th day to the 9th day, and received HMG injection from the 6th day to HCG day. The number of follicle≥14 mm and follicle ≥16 mm, endometrial thickness and pattern were observed on HCG day. Meanwhile, pregnancy rate, case of miscarriage, ectopic and ovarian hyperstimulation syndrome (OHSS) were recorded. Results: Endometrial thickness and endometrial pattern on HCG day in LE group were thicker than CC group (P＜0.01). The number of follicle ≥14 mm in LE group on HCG day was significantly decreased, and it showed a statistical difference compared with CC group