Effects of letrozole in combination with low-dose intramuscularinjection of human menopausal gonadotropin on ovulation and pregnancy of 156 patients with polycystic ovary syndrome

Zhihua Chen,Mengzhen Zhang,Junjuan Yang,Yuhuan Qiao

doi:10.12669/pjms.326.11391

Abstract

Objective:To explore the effects of letrozole (LE) in combination with low-dose intramuscular injection of human menopausal gonadotropin (HMG) on the ovulation induction and pregnancy of patients with polycystic ovary syndrome (PCOS).Methods:A total of 156 patients with PCOS infertility were randomly divided into an LE group, a clomiphene citrate (CC) group and an LE + HMG group (n= 52). LE and CC were orally taken according to the prescribed dosage on the 3rd-5th days of menstruation respectively, and 75 IU HMG was given through intramuscular injection. The ovulation induction parameters and pregnancy outcomes were observed.Results:The number of ovulation cycle of LE + HMG group was significantly higher than that of LE group (χ2=8.451, P<0.001). After injection of human chorionic gonadotropin, both endometrial thickness and number of mature follicles of LE + HMG group were significantly higher than those of other two groups (P<0.001), and the daily estradiol (E2) level was also higher (q=4.531, P<0.05). The pregnancy rate of LE + HMG group was 55.7%, which exceeded those of other two groups (compared to LE group, χ2=4.012, P<0.05). In LE + HMG group, the average medication cycle of clinically pregnant patients was (2.9 ± 0.3) weeks, which was significantly shorter than those of CC and LE groups (F=17.241, P<0.001).Conclusion:The regimen using LE in combination with low-dose intramuscular injection of HMG has satisfactory therapeutic effects on ovulation induction, short medication cycle and high clinical pregnancy rate, which is promising for treating patients with PCOS infertility.

Highlights

Polycystic ovary syndrome (PCOS), as one of the most common endocrine disorders for women of childbearing age, has the incidence rates of 5%-10%, accounting for 30%-60% of anovulatory infertility.[1]
Clomiphene citrate (CC) is the first ovulation induction drug widely used in clinical practice, but it has a certain impact on the endometrium and cervical mucus
Exclusion criteria: 1) Infertility patients caused by non-PCOS ovulatory disorder or other factors; 2) patients with history of ovarian surgery or complication with endometriosis or pelvic adhesion; 3) patients complicated with liver, kidney or thyroid dysfunction; 4) patients who did not receive treatment after enrollment according to the established regimen or gave up in the midst of treatment

Summary

Introduction

Polycystic ovary syndrome (PCOS), as one of the most common endocrine disorders for women of childbearing age, has the incidence rates of 5%-10%, accounting for 30%-60% of anovulatory infertility.[1] it remains difficult to design a proper regimen for the ovulation induction of PCOS patients. Clomiphene citrate (CC) is the first ovulation induction drug widely used in clinical practice, but it has a certain impact on the endometrium and cervical mucus. The pregnancy rate is relatively low despite high ovulation rate.[2] In recent years, letrozole (LE), a drug originally used to treat breast cancer, is a third-generation aromatase inhibitor.

Methods

Results

Conclusion