Clinical Effects Of Letrozole Ovulation Induction Treatment On Polycystic Ovary Syndrome With Different Body Mass Index

Objective and BackgroundPolycystic ovary syndrome(PCOS)is one of the most common diseases in gynecological endocrinology and its clinical manifestations are highly heterogeneous.Induction of ovulation is one common method to solve infertility.Clomiphene Citrate(CC)is still a first-line drug for clinical ovulation therapy.However,for some PCOS patients,CC has some bad tendency,such as thin endometrium,poor ovarian function,multiple follicular development or ovarian hyperstimulation.For the patients with high BMI,CC resistance is more likely to occur,and their ovulation rate and pregnancy rate are lower[1].Letrozole(LE)is the third generation of aromatase inhibitors(AIs),with characteristics of high efficiency and reversibility.Inhibiting the activity of aromatase enzyme,which is the speed limit in the process of synthetic estrogen,to make the body gonadotropin release increased,thus induced women mature follicle and discharge.Due to the short half-life of letrozole,it has little effect on cervical mucus and endometrium,many scholars have suggested that[2]LE can replace CC as a first-line ovulation drug in PCOS patients.For the infertility caused by PCOS,especially for patients with high BMI,it is necessary to further clinical observation of whether the ovulate can obtain the effect similar to the normal BMIIn this topic,we selected the PCOS patients with fertility requirements as the research object,according to different BMI,they will be divided into two groups.Starting to use the letrozole 5 mg/d in menses and last for five days,as the stimulate ovulation treatment,and observe the data of ovulation rate,pregnancy rate,live births rate between the two groups.ObjectiveCompare the clinical outcome of promote ovulation between the PCOS patients using the letrozole with different BIM and the development of newbornsMethodsThis retrospective study included 153 infertile PCOS women who visited the Provincial Hospital Affiliated to Shandong University between January 2014 and December 2015.According to BMI,divided the patients into obese group(BMI ?25 kg/)of 71 cases and the non-obese group(BMI<25 kg/m2)in 82 cases.On the 2nd?4 days of the patient's menstrual period,the basic endocrine and metabolic indicators of the patient were examined,and the patients began to give LE 5mg qd,orally,5d,and then promote ovulation monitoring and guidance to the same room,followed up to the delivery.And compare ovulation effect between the two groups.ResultsThe serum glucose,insulin,triglycerides,high-density lipoprotein(HDL)and total cholesterol levels in obese group were higher than the non-obese group(P =0.020,<0.001,0.002,<0.001,0.028),and HCG and E2 levels were below the non-obese group(P = 0.026),the differences were statistically significant.The advantage of the two groups of patients with ovarian follicle,ovulation rate,HCG day intrauterine membrane thickness and luteinizing hormone(LH)and progesterone(P),hormone level,pregnancy rate,miscarriage rate and live-birth rate comparison of differences had no statistical significance(P>0.05).Conclusion PCOS patients with different BMI were selected to promote ovulation,and the ovulation rate,pregnancy rate and live rate of obese PCOS patients were similar to those of non-obese patients.