Clinical effect of letrozole on ovulation induction in infertile patients with polycystic ovary syndrome after comprehensive intervention

doi:10.3969/j.issn.1006-7795.2020.04.005

Abstract

Abstract: Objective To investigate the clinical effect of letrozole in the treatment of infertile patients with polycystic ovary syndrome (PCOS) after comprehensive intervention. Methods A total of 144 infertile patients with PCOS who visited the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, from March to September 2019 were divided into two groups according to the principle of matching between groups. 96 patients in the observation group were treated with letrozole after 3 months of comprehensive intervention, while 48 patients in the control group were treated with letrozole alone. The changes of hormone levels before and after treatment were observed in the comprehensive intervention group, including luteinizing hormone (LH), follicle stimulating hormone (FSH), LH/FSH, total testosterone (TT), free testosterone (FT), anti-Müllerian hormone (AMH), and waist circumference. The ovulation rate was compared with each other between the two groups. Results There was no significant difference in infertility years, height, body weight, body mass index (BMI), waist circumference, hip circumference, LH, FSH and AMH between the two groups before treatment (P>0.05). After comprehensive intervention, the levels of LH, FSH, LH/FSH, TT, FT and AMH in the observation group were significantly lower than those before treatment (P<0.05), except that the waist circumference was lower than that before, but without statistically significant difference (P>0.05). Compared with the control group, the ovulation rate in the observation group was significantly increased, with statistically significant difference (P<0.05). Stratified analysis showed that the ovulation rate in the observation group was higher than that in the control group (P<0.05) in the patients with BMI<24 kg/m² before ovulation induction. However, in patients with BMI ≥ 24 kg/m², there was no significant difference between the two groups (P>0.05). Conclusion The clinical effect of letrozole in the treatment of infertility patients with PCOS after comprehensive intervention is significant, which can improve the both hormone level of patients and the ovulation rate, especially in patients with normal or low BMI.

Key words: polycystic ovary syndrome, infertility, comprehensive intervention, letrozole, ovulation induction

CLC Number:

R711.75

Dou Zhuli, Ruan Xiangyan, Ju Rui, Wang Binhong, Qin Shuang, Xu Xin, Yang Yu, Zhang Luping. Clinical effect of letrozole on ovulation induction in infertile patients with polycystic ovary syndrome after comprehensive intervention[J]. Journal of Capital Medical University, 2020, 41(4): 525-529.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2020.04.005

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2020/V41/I4/525

References 22

[1]	Alves E D, Bonfá A L O, Pigatto G R, et al. Photobiomodulation can improve ovarian activity in polycystic ovary syndrome-induced rats[J].J Photochem Photobiol B, 2019, 194:6-13.
[2]	Lizneva D, Suturina L, Walker W, et al. Criteria, prevalence, and phenotypes of polycystic ovary syndrome[J]. Fertil Steril, 2016,106(1):6-15.
[3]	Tannus S, Burke Y Z, Kol S. Treatment strategies for the infertile polycystic ovary syndrome patient[J]. Womens Health,2015,11(6):901-912.
[4]	中华医学会妇产科学分会内分泌学组及指南专家组.多囊卵巢综合征中国诊疗指南[J].中华妇产科杂志,2018,53(1):2-6.
[5]	Dumesic D A,Oberfield S E,Stener-Victorin E,et a1.Scientific statement on the diagnostic criteria,epidemiology,pathophysiology,and molecular genetics of polycystic ovary syndrome[J]. Endocr Rev,2015,36(5):487-525.
[6]	The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS)[J].Hum Reprod,2004,19(1):41-47.
[7]	赵越,阮祥燕,李扬璐,等.来曲唑联合高纯度尿促性素治疗氯米芬耐药的多囊卵巢综合征不孕患者的临床研究[J].首都医科大学学报,2016,37(4):431-436.
[8]	Dumesic D A, Akopians A L, Madrigal V K, et al. Hyperandrogenism accompanies increased intra-Abdominal fat storage in normal weight polycystic ovary syndrome women[J]. J Clin Endocrinol Metab, 2016, 101(11):4178-4188.
[9]	柳顺玉,阮祥燕,刘玉兰.屈螺酮炔雌醇片预处理治疗多囊卵巢综合征不孕患者的临床效果[J].中国医学前沿杂志(电子版),2015,7(4):106-108.
[10]	闵敏,阮祥燕,赵越,等.奥利司他综合干预对超重或肥胖型PCOS患者雄激素及糖脂代谢的影响[J].首都医科大学学报,2019,40(4):572-577.
[11]	Dumont A, Robin G, Catteau-Jonard S, et al. Role of anti-Müllerian hormone in pathophysiology, diagnosis and treatment of polycystic ovary syndrome:a review[J].Reprod Biol Endocrinol,2015, 13:137-147.
[12]	Tian X, Ruan X, Mueck A O, et al. Anti-Müllerian hormone levels in women with polycystic ovarian syndrome compared with normal women of reproductive age in China[J]. Gynecol Endocrinol, 2014, 30(2):126-129.
[13]	Tian X, Ruan X, Mueck A O, et al. Serum anti-Müllerian hormone and insulin resistance in the main phenotypes of non-obese polycystic ovarian syndrome women in China[J]. Gynecol Endocrinol, 2014, 30(11):836-839.
[14]	Jin J, Ruan X, Hua L, et al. Prevalence of diminished ovarian reserve in Chinese women with polycystic ovary syndrome and sensitive diagnostic parameters[J]. Gynecol Endocrinol, 2017,33(9):694-697.
[15]	罗棹文,周红.多囊卵巢综合征中抗苗勒管激素的相关研究进展[J]. 生殖医学杂志,2019,28(12):1521-1525.
[16]	李红然,张育婧,李春美,等. 多囊卵巢综合征不孕患者血清抗苗勒管激素水平与药物诱导排卵反应的关系[J]. 中华实用诊断与治疗杂志,2020,34(3):308-311.
[17]	Cela V,Obino M E R,Alberga Y,et al.Ovarian response to controlled ovarian stimulation in women with different polycystic ovary syndrome phenotypes[J]. Gynecol Endocrinol,2018,34(6):518-523.
[18]	谢言信,赵雅男,林海燕,等.抗苗勒氏管激素在多囊卵巢综合征患者行人工授精预测价值的评估[J].中山大学学报(医学科学版),2019,40(1):90-97.
[19]	许远芳,黄元华.AMH在PCOS患者中评估卵巢储备及诊断价值[J].国际生殖健康/计划生育杂志,2019,38(3):230-235.
[20]	张素萍.来曲唑治疗不同体质量指数多囊卵巢综合征患者临床分析.济南:山东大学,2018.
[21]	山惠枝,沈晓月,蒋玥,等.体重指数对PCOS患者IVF/ICSI治疗的影响[J].生殖医学杂志,2019,28(6):629-635.
[22]	李予,马芸,李琳,等.体质指数对多囊卵巢综合征不孕患者体外受精治疗的影响[J].广东医学,2013,34(1):22-27.