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目的:研究来曲唑(LE)在多囊卵巢综合征(PCOS)患者超促排卵行IVF-ET中的应用。方法:90例PCOS患者随机分成LE组(n=49)和GnRHa长方案组(对照组,n=41),比较组间的促排卵天数、促性腺激素(Gn)使用剂量、获卵数、受精率、卵裂率、优质胚胎率、种植率和临床妊娠率以及卵巢过度刺激综合征(OHSS)发生率。结果:LE组与对照组的Gn剂量分别为18.0±6.6支和29.3±9.5支,促排卵天数分别为7.8±1.3 d和10.0±1.2 d,获卵数分别为7.9±4.1个和19.8±7.2个,MⅡ卵率分别为74.5%和82.9%,启动周期中-重度OHSS发生率4.1%(2/49)vs 29.3%(12/41),差异均具有统计学意义(P<0.05),而组间的种植率和临床妊娠率(33.3%vs27.5%和51.1%vs 48.5%)差异无统计学意义(P>0.05)。结论:LE用于PCOS超促排卵行IVF-ET与传统的GnRHa长方案相比,在不影响临床妊娠率的前提下,可以有效减少促排卵时间和Gn使用剂量,降低OHSS发生风险,具有极大的临床应用前景。
Objective: To study the application of letrozole (LE) in IVF-ET in patients with polycystic ovary syndrome (PCOS). Methods: Ninety patients with PCOS were randomly divided into LE group (n = 49) and long GnRHa group (n = 41). The days of ovulation, the dosage of gonadotrophin (Gn) Fertilization rate, cleavage rate, quality embryo rate, implantation rate and clinical pregnancy rate, and ovarian hyperstimulation syndrome (OHSS) incidence. RESULTS: The Gn doses of LE group and control group were 18.0 ± 6.6 and 29.3 ± 9.5, respectively. The days of ovulation induction were 7.8 ± 1.3 d and 10.0 ± 1.2 d, respectively. The number of oocytes retrieved was 7.9 ± 4.1 and 19.8 ± 7.2 (P <0.05). The rates of M Ⅱ eggs were 74.5% and 82.9% respectively, and the incidence of moderate-severe OHSS was 4.1% (2/49) vs 29.3% (12/41) The implantation rate and clinical pregnancy rate (33.3% vs27.5% vs 51.1% vs48.5%) were not statistically different between groups (P> 0.05). Conclusions: Compared with the traditional GnRHa long-term regimen, LE can effectively reduce ovulation time and Gn dosage and reduce the risk of OHSS compared with the traditional GnRHa regimen. Large clinical application prospects.