在患有多囊性卵巢综合征的患者进行第一次排卵诱导周期的扩展与常规莱特醇治疗方案:一项前性随机对照试验
Xiuxian Zhu1,2, Jingwen Lang1,2, Qiaoling Wang1,2
1Department of Assisted Reproductive Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, PR China.
Human reproduction open
|August 6, 2024
概括
在患有多囊性卵巢综合征 (PCOS) 的女性中,延长列醇 (LE) 治疗方案与常规治疗方案相比没有显著增加排卵率. 这表明,标准的LE方法仍然是建议在PCOS患者的第一线排卵诱导.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 不孕症治疗 不孕症治疗
- 多囊性卵巢综合征 (PCOS) 是一种疾病.
背景情况:
- 莱特 (LE) 是PCOS的第一线排卵诱导剂.
- 一部分PCOS患者对传统的LE疗法没有反应.
- 扩展LE疗法对非响应患者有希望,但对于所有PCOS患者作为首选的适用性尚未探索.
研究的目的:
- 为了比较延长莱特醇 (LE) 治疗方案的疗效与在患有多囊性卵巢综合征 (PCOS) 的患者中诱导排卵的常规治疗方案.
- 为了确定延长LE治疗方案是否会在PCOS患者的第一个排卵诱导周期中产生更高的排卵率.
主要方法:
- 一项前性随机对照试验,涉及148名患有PCOS的女性患者,她们正在经历第一次排卵诱导周期.
- 参与者被随机分配,接受延长 (7天每天5毫克LE) 或常规 (5天每天5毫克LE) 治疗方案.
- 主要结局是排卵率;次要结局包括临床妊娠,卵泡发育和多胎妊娠率.
主要成果:
- 扩展LE疗法 (90.54%) 的排卵率略高于传统疗法 (79.73%),但这种差异在统计学上并不显著 (P=0.065).
- 两组之间在预排卵毛囊数量,临床怀孕率或活产率方面没有发现显著差异.
- 没有报告过卵巢过度刺激综合征的病例,所有观察到的怀孕都是单独的,没有新生儿缺陷.
结论:
- 与PCOS患者在第一次排卵诱导周期中的常规治疗方案相比,扩展列特 (LE) 治疗方案对排卵率没有显示出统计学上优异的效果.
- 目前不建议改变标准LE策略;对于特定的非响应群体,可以谨慎考虑扩展治疗方案.
- 需要进行进一步的大规模前性试验,以评估不同PCOS亚组的不同LE治疗持续时间.
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