Clinical Research On The Effect Of Different Ovulation Induction Programs On Infertile Women With Polycystic Ovary Syndrome

Objective To investigate the safety and efficacy of different ovulation induction protocols on infertile women with polycystic ovarian syndrome(PCOS).Datum and Method1.Subject investigated From July 2015 to June 2017,195 patients with PCOS infertility were selected from gynecological endocrine clinic of our hospital.The patients were 25 years old to 35 years old,infertile for 1-5 years,married,normal sexual life.Hysterosalpingography showed no abnormal shape of the uterus,including at least one side of the fallopian tube unobstructed.No uterine leiomyoma or ovarian cyst detected by ultrasound.Normal liver and kidney function.The man’s semen is normal and normal.Ovulatory drugs have not been used in the past three months.All patients have signed informed consent to ovulation promotion.2.Method2.1Groups Group A(n=48)received clomiphene(CC),group B(n=50)received letrozole(LE),group C(n=47)received CC + LE,and group D(n=50)received LE + LE.2.2Medication scheme The group A used for menstrual cycle or withdrawal bleeding from the fifth day oral CC 50 mg Bid,group B since the menstrual cycle began the fifth days of oral administration of LE 2.5mg Bid,11~12 of the menstrual cycle day vaginal ultrasound in monitoring follicle size.Group C since the menstrual cycle began the fifth days of oral administration of CC 50 mg Bid,the largest follicle diameter <10mm was monitored by vaginal ultrasound on the 11~12 of menstruation,Continue to take it for 5 days and then have a vaginal ultrasound.Group D since the menstrual cycle began the fifth days of oral administration of LE 2.5mg Bid,the largest follicle diameter <10mm was monitored by vaginal ultrasound on the 11~12 of menstruation,Continue to take it for 5 days and then have a vaginal ultrasound.2.3Follicular monitoring When the largest follicle diameter ≥18mm after intramuscular injection of HCG6000-8000 IU,promote ovulation,and guide the patients48 hours after ultrasound observation of follicle rupture,follicular break with progesterone capsule 200 mg qd or diproprogesterone 10 mg qd was given for 14 days.2.4Cyesiognosis After 14 days of luteal support therapy,urine HCG or blood HCG were examined to determine pregnancy.If it is positive,14 days after the B-ultrasound examination,the diagnosis of the fetal heart pulsation in the uterine cavity is the diagnosis of clinical pregnancy.2.5Observation index The number of mature follicles,endometrium thickness of on HCG day,ovulation rate,clinical pregnancy rate,early abortion rate,and so on in the four groups were observed.The difference was statistically significant(P < 0.05).Results1.A total of 492 treatment cycles were completed in 195 patients with PCOS infertility.Four groups of different scheme based hormone levels,ages,BMI,years of infertility was no significant difference in P>0.05.2.The number of mature follicles in group A was higher than that in group B,and the difference was statistically significant(P<0.05).As for ovulation rate and pregnancy rate,the differences between group A and group C,group D,group B and group C,group D all have statistical meanings(P<0.05),while the difference between group C and goup D don,t(P>0.05).The thickness of endometrium in group C and group D was better than that of group A on HCG day,which might be more suitable for the implantation of fertilized eggs.There was no statistically significant difference in the early abortion rate among all groups(P=0.73).There were no complications such as ovarian hyperstimulation(OHSS)among the four groups,but only a few patients had side effects such as nausea,fever,and vaginal bleeding.Conclusion Letrozole + letrozole can improve the ovulation rate and pregnancy rate of infertile patients with PCOS.This may be an alternative option for ovulation induction.