来曲唑和氯米芬临床促排卵效果的
比较
【摘要】目的比较芳香化酶抑制剂——来曲唑和氯米芬促排卵的临床疗效。

方法将62例不孕妇女随机分成2组，其中来曲唑组28例，氯米芬组34例，2组分别于月经周期第3～7天每天口服来曲唑 mg或氯米芬50 mg，均于月经第11天开始阴道B超监测卵泡大小和子宫内膜厚度。

至最大卵泡平均直径≥18 mm时，肌注人绒毛膜促性腺激素10000 U。

结果肌注HCG当日最大卵泡MFD、周期排卵率、异位妊娠率2组比较，差异无统计学意义。

来曲唑组HCG日优势卵泡数、HCG日子宫内膜厚度、宫颈黏液评分、临床周期妊娠率均优于氯米芬组。

其中来曲唑组发生未破卵泡黄素化综合征1例，而氯米芬组有3例。

2组均未出现卵巢过度刺激综合征。

结论来曲唑用于不孕妇女的促排卵治疗优于氯米芬，将来有可能替代氯米芬作为一线的诱发排卵药物。

【关键词】不孕症；来曲唑；氯米芬；促
排卵药物
Abstract： Objective To compare the clinical effects of letrozole (LE) and clomiphene citrate (CC) on ovulation induction. Methods 62 infertile women with type Ⅱ reproductive endocrine abnormality were randomly divided into two groups, with 28 women in LE group and 34 women in CC group. The women in both groups took mg letrozole and 50 mg clomiphene citrate respectively, once a day successively from the third to the seventh day of menstrual period (5 days). The follicle diameter and endometrial thickness were monitored by the transvaginal ultrasound as of the eleventh day. When the max follicle diameter (MFD) was ≥18 mm, the women were injected with human chorionic gonadotropin (HCG) 10000 U intramuscularly. Results No significant difference was found between the two
groups in MFD on HCG days, cycle ovulation rate and ectopic pregnancy rate (). LE group had the higher average dominant follicle numbers, endometrial thickness on HCG days, cervical mucus scores and clinical pregnancy rate than CC group (). There was one patient with luteinized unruptured follicle syndrome (LUFS) in LE group and three in CC group. Neither of the groups had ovary overstimulation syndrome. Conclusion Letrozole has more advantage than clomiphene citrate in ovulation treatment of infertile women. It is expected to replace clomiphene citrate as a first-line drug to induce ovulation. Key words: infertility; letrozole; clomiphene citrate; ovulation induction 排卵障碍是引起不孕的主要原因之一。

氯
米芬(CC)是目前临床应用最广的促排卵药
物，但其对子宫内膜和宫颈黏液有潜在的不
良影响，使其促排卵率高但妊娠率并不理想。