Clinical effect of different doses of Letrozole combined with low-dose HMG on infertile patients with polycystic ovary syndrome#br#
HE Shan1 LIU Dayan2 NING Yan3 CHEN Pengdian3 JIANG Shaoyan1 MA Fei3 WU Jiaman3 WU Fangting1
1.Department of Pharmacy, the Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Guangdong Province, Shenzhen 518028, China;
2.Reproductive Center, the Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Guangdong Province, Shenzhen 518028, China;
3.Department of Traditional Chinese Medicine, the Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Guangdong Province, Shenzhen 518028, China
Abstract：Objective To explore the effect of different doses of Letrozole combined with low-dose human menopausal gonadotropin (HMG) on infertile patients with polycystic ovary syndrome (POCS), and to provide guidance for clinical ovulation promotion programs of patients. Methods A total of 189 infertility patients with PCOS who were received routine ovulation induction treatment in Reproductive Center, the Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University from January 2018 and December 2020 as research subjects. They were divided into group A (Letrozole 2.5 mg), group B (Letrozole 5.0 mg), and group C (Letrozole 7.5 mg). After five days of Letrozole oral administration from two to five days of menstruation, HMG was intramuscular injected. The levels of luteinizing hormone (LH), estrdiol (E2), and testoserone (T) in each group on human chorionic gonadotrophin (HCG) day; number of follicular maturation days, doses and days of HMG, number of follicular development, endometrial thickness, and the proportion of patients with clinical pregnancy rate, number of miscarriages, number of biochemical pregnancies, number of ovarian hyperstimulation syndrome (OHSS), and number of multiple pregnancies were observed and compared. Results There were no significant differences in endometrial thickness and maximum follicular diameter among three groups on HCG days (P > 0.05); the number of follicular maturation days and days of HMG in groups B and C were longer than those in group A, the doses of HMG were lower than those in group A, and the number of follicles ≥18 mm and ≥15 mm in HCG days were more than those in group A, and the differences were statistically significant (P < 0.05). There were no significant differences in LH and T levels among three groups in HCG days (P > 0.05); E2 levels of HCG days in group B and C were higher than those in group A, and the differences were statistically significant (P < 0.05). No OHSS occurred in three groups. There were no significant differences in the proportion of patients with clinical pregnancy, multiple pregnancies, miscarriages, and biochemical pregnancies among three groups (P > 0.05). Conclusion Different doses of Letrozole combined with low-doses of HMG can effectively improve follicular growth and development in patients with PCOS ovulation disorder. In PCOS infertile patients, Letrozole 5.0 mg is taken orally from the two to five days of menstruation for five days, after five days, combined with HMG, the treatment effect is satisfactory, the number of ovulation induction days is short, the incidence of OHSS is low, and the clinical pregnancy rate is high, which had high clinical application value.
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