拮抗剂方案添加来曲唑在PCOS助孕中的效果评价  

Evaluation of the effect of antagonist protocol combined with letrozole in assisted pregnancy of PCOS

作　　者：哈丽代姆·斯迪克 艾海权[1] 阿瓦古丽·阿卜杜米吉提 腊晓琳[1] Halidaimu Sidike;AI Haiquan;Awaguli Abudumijiti;LA Xiaolin(Department of Reproductive Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院生殖医学中心,乌鲁木齐830054

出　　处：《新疆医学》2025年第2期133-136,共4页Xinjiang Medical Journal

基　　金：国家自然科学基金(项目编号:81960289);中央引导地方科技发展专项基金项目(项目编号:ZYYD2024ZY07);省部共建中亚高发病成因与防治国家重点实验室(项目编号:SKL-HIDCA-2024-GX2)。

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者拮抗剂方案(GnRH-ant)中添加来曲唑(LE)促排卵对促排卵周期及最终助孕结局的影响;方法回顾性分析2023年9月至2024年11月在本院接受GnRH-ant促排卵的121例PCOS不孕症患者,按是否添加LE分为观察组(42例)、对照组(79例),比较两组间的基本资料、促排卵过程及助孕结局;结果两组年龄、不孕年限、BMI、基础FSH、基础E_(2)、基础LH及AMH水平组间无统计学差异;观察组的Gn启动剂量、总量及用药天数、拮抗剂总量、OHSS发生率、早发LH峰发生率均低于对照组;观察组拮抗剂添加时间更晚、使用天数更短,观察组D6及HCGE2均低于对照组,组间差异有统计学意义(P<0.01);观察组比对照组平均获卵数、HCG阳性率、临床妊娠率更高;结论PCOS不孕症患者拮抗剂方案联合使用LE,可能减少Gn启动剂量、用药天数及总量,延迟拮抗剂首次添加时间,减少拮抗剂使用总量及用药天数并减少早发LH峰发生率;在PCOS拮抗剂方案促排卵时添加LE可以作为常规拮抗剂方案促排卵的替代和补充。Objective To explore the impact of adding letrozole(LE)to the antagonist protocol(GnRH-ant)for ovulation induction on the ovulation induction cycle and the final pregnancy outcome in patients with polycystic ovary syndrome(PCOS).Method A retrospective analysis was conducted on 121 PCOS infertile patients who received GnRH-ant ovulation induction in our hospital from September 2023 to November 2024.They were divided into the observation group(42 cases)and the control group(79 cases)based on whether LE was added.The basic data,ovulation induction process,and pregnancy outcome were compared between the two groups.Results There were no statistically significant differences between the two groups in terms of age,duration of infertility,BMI,basal FSH,basal E_(2),basal LH and AMH levels.The Gn initiation dose,total dose,duration of medication,total dose of antagonist,incidence of OHSS and early LH peak in the observation group were all lower than those in the control group.The time of antagonist addition was later and the duration of use was shorter in the observation group.The E2 levels on D6 and HCGE2 in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.01).The average number of retrieved oocytes,HCG positive rate and clinical pregnancy rate in the observation group were all higher than those in the control group.Conclusion The combined use of LE in the antagonist protocol for PCOS infertility patients may reduce the Gn initiation dose,total dose and duration of medication,delay the first addition time of the antagonist,reduce the total dose and duration of antagonist use and the incidence of early LH peak.The addition of LE in the antagonist protocol for ovulation induction in PCOS can be used as an alternative and supplement to the conventional antagonist protocol for ovulation induction.

关 键 词：多囊卵巢综合征 拮抗剂方案 来曲唑 不孕症 排卵障碍 

分 类 号：R711.6[医药卫生—妇产科学]