Observation The Clinical Effects On Overweight Patients With Polycystic Ovary Syndrome Treated By Different Induce Ovulation Schemes

Objective:To evaluate the clinical effects on the high Body Mass Index(BMI)patients with polycystic ovary syndrome treated by different induce ovulation schemes.Materials and Methods:A prospective analysis was performed in 180 cycles(patients BMI≥24kg/m~2)which suffered natural intercourse or intrauterine insemination(IUI)after induce ovulate using different schemes.They were divided into 3 groups based on different protocols of induce ovulation:LE(Letrozole)(group A,60 cycles),LE and gonadotropin(group B,60 cycles)with gonadotropin(group C,60 cycles).The clinical data and the outcome of pregnant were compared among the 3 groups.Results:There was no significant differences in patients’mean age(28.30±3.86VS 28.73±2.68 VS 27.75±3.49 year-old,P>0.05),mean duration of infertility(2.24±1.28 VS 2.05±1.06 VS 2.05±0.78 years,P>0.05),mean BMI(26.77±2.79 VS 26.84±2.09 VS 27.31±2.30 kg/m~2,P>0.05),the mean number of pregnancy(0.67±0.65 VS 0.50±0.62 VS 0.62±1.04,P>0.05)、basis LH(8.76±5.76 VS 8.64±4.67 VS 7.45±5.55 U/L,P>0.05)、FSH(5.05±1.48 VS 4.73±1.10 VS 4.90±1.12 U/L,P>0.05)、E2(48.58±13.83VS 49.57±45.28 VS 47.06±10.47 pmol/L,P>0.05)、T(0.71±0.23 VS0.82±0.54 VS 0.77±0.27 nmol/L,P>0.05).However,mean endometrial thickness on HCG day of group A significantly lower than the other groups(7.93±1.29 VS 8.84±1.40 VS 8.78±1.83mm,P<0.05).Group B achieved significantly higher mean duration of medication than other two groups(8.93±3.80 VS 12.57±2.91 VS 11.38±2.85 days,P<0.05).Group A got lower follicles which diameter bigger than 14 mm than the other groups(1.25±0.54 VS 2.05±1.20 VS 1.87±1.21,P<0.05).The major follicle develop rate in group A higher than group B and C significantly(80%VS60%VS 58.3%,P<0.05).The rate of Ovarian hyperstimulation syndrome in group C higher than group A and B(6.7%VS 0 VS 1.7%,P<0.05).There was no statistically difference between the three groups in terms of biochemical pregnancy rate,clinical pregnancy rate.Conclusion:letrozole is a second-line induce ovulation drugs that the effect of inducing ovulation to a higher body mass index patients with polycystic ovary syndrome is obvious.And the cost is low without pain.It is easier for patients to follow.It can be used as preferred induce ovulation drugs for PCOS patients with a high body mass index.For less severe and younger patients should focus on the effects of the cumulative rates of pregnancy when applying letrozole,and try several cycles before change to Gn.For patients with polycystic ovary syndrome using gonadotropins to induce ovulation that more follicle growth rate is significantly high and the incidence of ovarian hyperstimulation is also high,meanwhile it need to monitor closely and control the dosage in time or stop inducing.