The Study Of Comparation Of TMXoxifen And Comiphene In Controlled Ovarian Stimulation

Objective:To comparate COS and pregnancy results of Tamoxifen and clomiphene in PCOS patients.Methods:1.Study samples:365 cases of pcos patients were collected who were going to be trated with COS in our reproductive medicine center in 2009. Their age ranged from 23 to 35 years, average age was 29±3 years. All the patients in the study were knowing the fact of a case and voluntary.2. Methods:2.1 Groups:Group TMX (180 cases) and group cc(185 cases)2.2 Drugs:TMX:10mg/tablet, CC:50mg/tablet2.3 Drug programme:In TMX group, TMX 20mg/d was given to the patients from menstrual cycle day 5 to day 9, and then HMG 75——150IU was used up to day HCG. In CC group, CC 100 mg/d was given to the patients from menstrual cycle day 5 to day 9, and then HMG 75——150IU was used up to day HCG. As soon as the diameter of mature follicle was at the least bigger than 18mm, hCG 5000IU-10000IU was used to induced ovulation. Progesterone 20mg/d was used for 15 days after ovulation confirmed by B-ultra sonography.30 days later, clinical pregrancy was diagnosed by vaginal ultra sonography when pulsation of fatal heart was seen.2.4 Detecting growth of follicle and endometrium by vaginal B-ultra sonography: At day HCG, recording number of follicles which diameter is bigger than 14mm or 16mm respectively, thickness and morphology of endometrium.2.5 Detecting plasma sexual hormone:At menstrual cycle day 3 we detected basal endocrinal secretion, the consentration of FSH,LH,E2,PRL,T of plasma. When the diamiter of dominant follicle was bigger than 16mm we detected urinary LH peak. At day HCG we detected consentration of E2,LH of plasma. At the seventh day after ovulation we detected consentration of E2 and P of plasma.3.Statistical methods:All datas were analyzed by SPSS 16.0, including T-test, Wilcoxon test,χ2 test and Fisher test. P<0.05 was considered statistically significant.Results:1.Group TMX have 180 patients,180 cycles was finished the study. Group CC have 185 patients,185 cycles was finished the study. There have no statistical significance in age, infertile duration, body weight index and testosterone plasma consentration of patients.2.≥14mm follicles,≥16mm follicles, concentration of E2 and LH have no significant difference in group TMX and group CC at Day HCG. The endometrial thickness of group TMX is thicker than group CC at day HCQThe difference has statistical significance.the patients'endometrium in group TMX is thicker than 7mm, but in group CC, there are 3 patients'endometrium is thinner than 7mm. At the seventh day after ovulation, plasma consentration of E2 and P in group TMX is higher than in group CC, but this has no statistical significance. The total HMG dose in group TMX is more than group CC, and duration of group TMX is longer too. The pregnancy rate is higher and abortion rate is lower in group TMX than in group CC, and it has statistical significance.Conclusion:TMX has similar healing effect with CC in COS, and its pregnancy rate and results are satisfied too.