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

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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.

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