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目的:探讨来曲唑(LE)联合FSH在多囊卵巢综合征(PCOS)患者IVF-ET或ICSI中的应用及效价分析。方法:回顾性分析接受IVF-ET/ICSI治疗的170名PCOS不孕患者,分为LE组(LE-FSH组,n=59)与对照组(GnRHa-FSH组,n=111)。比较组间促排卵、妊娠结局、每周期治疗费用及药物效价比。结果:LE组和对照组FSH用药天数分别为6.3±1.9 d vs 13.0±2.3、用药量为615.6±284.6 IU vs l 504.9±424.9 IU,组间比较有显著性差异(P<0.01);hCG注射日E2值分别为1 965.3±1119.7 pmol/L vs 12 660.2±7 254.2 pmol/L,获卵数分别为6.5±3.3 vs16.6±7.9,组间比较均有显著性差异(P<0.01);受精率、胚胎种植率分别为66.1%vs71.6%,25.58%vs 23.63%,临床妊娠率为49.12%vs 34.48%,组间比较无显著性差异(P>0.05);中-重度OHSS发生率分别为O%和6.89%,组间比较差异有显著性(P<0.01)。LE组每刺激周期药费(2 877±1 240元)及每妊娠周期药费(3 014±1581元)显著低于对照组(6 561±1 852元、8774±1970元)(P<0.01),治疗效价比分别为5 959元vs 30 067元。结论:LE联合促卵泡素可有效运用于PCOS患者的IVF-ET中,较传统的GnRHa-FSH促排卵相比,无OHSS的发生、费用低、效价比高,且不影响妊娠率和种植率。
Objective: To investigate the application and the analysis of letrozole (LE) combined with FSH in IVF-ET or ICSI in patients with polycystic ovary syndrome (PCOS). Methods: A total of 170 infertile women with PCOS treated with IVF-ET / ICSI were retrospectively analyzed and divided into LE group (n = 59 for LE-FSH group) and control group (n = 111 for GnRHa-FSH group). Ovulation, pregnancy outcomes, treatment costs per week, and drug titer were compared between groups. Results: The days of FSH administration in LE group and control group were 6.3 ± 1.9 d vs 13.0 ± 2.3, the dosage was 615.6 ± 284.6 IU vs 504.9 ± 424.9 IU respectively (P <0.01); hCG injection Day E2 values were 1 965.3 ± 1119.7 pmol / L vs 12 660.2 ± 7 254.2 pmol / L, respectively. The number of oocytes retrieved was 6.5 ± 3.3 vs 16.6 ± 7.9, respectively. There was significant difference between the two groups (P <0.01). The rates of fertilization and embryo implantation were 66.1% vs 71.6%, 25.58% vs 23.63%, respectively. The clinical pregnancy rate was 49.12% vs 34.48%, with no significant difference between the two groups (P> 0.05). The incidence of moderate-severe OHSS Respectively, O% and 6.89%, the difference between the groups was significant (P <0.01). In the LE group, the cost of medication (2 877 ± 1 240 RMB) per stimulation period and drug expenditure per gestation period (3 014 ± 1 581 RMB) was significantly lower than that of the control group (6 561 ± 1 852 RMB, 8774 ± 1970 RMB) (P <0.01 ), The treatment cost ratio were 5 959 yuan vs 30 067 yuan. CONCLUSION: LE combined with follicle stimulating hormone can be effectively used in IVF-ET in patients with PCOS. Compared with traditional GnRHa-FSH ovulation induction, LE combined with follicle stimulating hormone has no OHSS, low cost and high valence ratio, and does not affect the pregnancy rate and implantation rate.