来曲唑联合克罗米芬对体外受精胚胎移植患者卵巢储备功能及妊娠结局的影响  

Effects of letrozole combined with clomiphene on ovarian reserve function and pregnancy outcome in patients with in vitro fertilization and embryo transfer

作　　者：刘琦[1] 贾楠[1] 宋小兵[1] 葛恒涛 张翠莲[1] Liu Qi;Jia Nan;Song Xiaobing;Ge Hengtao;Zhang Cuilian(Reproductive Medicine Center,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院生殖医学中心,郑州450003

出　　处：《中国实用医刊》2022年第4期89-92,共4页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划项目(201702210)。

摘　　要：目的探究来曲唑联合克罗米芬对体外受精胚胎移植(IVF-ET)患者卵巢储备功能及妊娠结局的影响。方法抽取2018年5月至2020年5月河南省人民医院收治的138例卵巢功能低下患者作为研究对象,所有患者均接受IVF-ET,按照随机信封法分为观察组(来曲唑联合克罗米芬治疗)与对照组(克罗米芬治疗),每组69例。比较两组促排卵参数及治疗前后卵巢储备功能指标、血清基质金属蛋白酶-9(MMP-9)、抗苗勒管激素(AMH)水平。随访妊娠结局,比较两组种植率、临床妊娠率及流产率。结果观察组人绒毛膜促性腺激素日子宫内膜厚度大于对照组,获卵数、可利用胚胎数及优质胚胎数均多于对照组(P均<0.05)。治疗前,两组各项卵巢储备功能指标比较差异未见统计学意义(P>0.05)。治疗后,两组促卵泡生成素(FSH)均低于治疗前,雌二醇、孕酮高于治疗前(P<0.05);且观察组治疗后FSH低于对照组,雌二醇、孕酮高于对照组(P<0.05)。治疗前,两组血清MMP-9、AMH水平比较差异未见统计学意义(P>0.05);治疗后,观察组MMP-9、AMH水平低于对照组,差异有统计学意义(P<0.05)。观察组种植率(53.01%,44/83)、临床妊娠率(37.68%,26/69)均高于对照组(30.00%,27/90;21.74%,15/69),流产率(7.69%,2/26)低于对照组(40.00%,6/15),差异有统计学意义(P<0.05)。结论来曲唑联合克罗米芬应用于行IVF-ET患者,在改善患者卵巢储备功能方面有着突出效果,有利于提升妊娠结局,降低流产率。Objective To investigate the influence of letrozole combined with clomiphene on ovarian reserve function and pregnancy outcome in patients with in vitro fertilization and embryo transfer(IVF-ET).Methods A total of 138 patients with ovarian hypofunction treated in Henan Provincial People’s Hospital from May 2018 to May 2020 were selected as the research object.All patients received IVF-ET,and they were divided into observation group,treated with letrozole combined with clomiphene,and control group,treated with clomiphene,according to random envelope method,with 69 cases in each group.The ovulation induction parameters,preooperative and postoperative ovarian reserve function indexes,levels of serum matrix metalloprotein-9(MMP-9)and anti-Mullerian hormone(AMH)were compared between the two groups.And the pregnancy outcomes were followed up to compare implantation rate,clinical pregnancy rate and abortion rate of the two group.Results The endometrial thickness on human chorionic gonadotrophin day of the observation group was greater than that of the control group,and the number of eggs,available embryos,and high-quality embryos in the observation group were more than those in the control group(all P<0.05).There was no significant difference in ovarian reserve function indexes between the two groups before treatment(P>0.05).After treatment,follicle-stimulating hormone(FSH)of the two groups were lower than those before treatment,while estradiol and progesterone were higher than those before treatment(P<0.05).And FSH of the observation group was lower than that of the control group,while estradiol and progesterone were higher than those of the control group after treatment(P<0.05).There was no significant difference in the levels of serum MMP-9 and AMH between the two groups before treatment(P>0.05);after treatment,the levels of MMP-9 and AMH of the observation group were lower than those of the control group(P<0.05).The implantation rate(53.01%,44/83)and clinical pregnancy rate(37.68%,26/69)in the observation group we

关 键 词：来曲唑 克罗米芬 体外受精胚胎移植 卵巢储备功能 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]