| 摘要: |
| 目的:比较多囊卵巢综合征(PCOS)患者从月经周期第3天或第5天开始口服来曲唑(LE)的促排卵疗效。方法:194例经减重、抗雄激素或胰岛素增敏治疗后的有生育要求的PCOS患者,根据患者胰岛素抵抗评估的稳态指数模型(HOMA-IR)分为胰岛素抵抗组(n=72例)与非胰岛素抵抗组(n=122例),非胰岛素抵抗组患者单用LE促排卵,胰岛素抵抗组患者在口服LE同时联合服用二甲双胍1500 mg/d。两组组内分别根据口服LE的起始时间不同分为D3组、D5组,即从月经周期或孕激素撤退性出血第3天或第5天起口服LE 5 mg/d,连服5天;比较不同促排启动时间的排卵率、妊娠率和活产率。结果:胰岛素抵抗组中D3组较D5组周期排卵率(72.5%vs 69.0%)、妊娠率(45.7%vs 36.4%)、活产率(34.3%vs 27.3%)、流产率(11.4%vs 9.1%)更高,但差异无统计学意义(P>0.05)。非胰岛素抵抗组中D3组较D5组妊娠率(50.0%vs 42.6%)、活产率(39.3%vs29.5%)更高,周期排卵率(75.2%vs 80.0%)、流产率(10.7%vs 13.1%)更低,但差异均无统计学意义(P>0.05)。结论:对于有生育要求的PCOS患者的促排卵治疗,无论是月经周期第3天或第5天开始服用LE,其促排卵效果无明显差异。 |
| 关键词: 多囊卵巢综合征 来曲唑 二甲双胍 胰岛素抵抗 |
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| Analysis of the Optimal Time of Letrozole on Ovulation Induction for Women with Polycystic Ovary Syndrome |
| FENG Xue;TAN Jing;WANG Qiuyi |
| (West China Second University Hospital of Sichuan University,Key Laboratory of Birth Defects and Related Diseases of Women and Children,Ministry of Education) |
| Abstract: |
| Objective: The aim of this study was to compare the ovulation induction efficiency of two different initiation times( start from 3 rd or 5 th day of the menstrual cycle) of letrozole( LE) in the patients with polycystic ovary syndrome( PCOS).Methods: 194 PCOS patients with fertility requirement were enrolled into this prospective randomized trial after losing weight,treatment of anti-androgen or increasing sensitivity of insulin. According to HOMA-IR,we grouped the patients into insulin resistance( HOMA-IR ≥ 2. 77) and non-insulin resistance( HOMA-IR<2. 77).Patients with insulin resistance( n = 72) took LE combined metformin 1500 mg per day,while patients with non-insulin resistance took LE alone.Then the two groups were divided into D3 group and D5 group according to the different starting time of oral letrozole respectively.Group D3 patients took LE 5. 0 mg daily for 5 days from 3rd day of the menstrual cycle or progesterone withdrawal hemorrhage.Group D5 patients started from5 th day.The ovulation rate,pregnancy rate and livebirth rate were compared between two groups.Results: In the insulin resistance group,D3 group had higher ovulation rate( 72. 5% vs 69. 0%),pregnancy rate( 45. 7% vs 36. 4%),live birth rate( 34. 3% vs 27. 3%) and abortion rate( 11. 4% vs 9. 1%) than D5 group,however,the difference was not statistically significant( P > 0. 05). In the non-insulin resistance group,the pregnancy rate( 50. 0% vs 42. 6%) and live birth rate( 39. 3% vs 29. 5%) were higher in D3 group than in D5 group,the ovulation rate( 75. 2% vs 80. 0%) and abortion rate( 10. 7% vs 13. 1%) were lower,but the difference was not statistically significant( P>0. 05).Conclusions: There were no significant differences of ovulation induction efficiency for PCOS patients who started LE on the 3rd or 5th day of cycle. 更多 |
| Key words: Polycysticovarysyndrome Letrozole Metformin Insulinresistance |
