期刊文献+

来曲唑联合促卵泡素在PCOS患者IVF-ET中的应用及效价分析 被引量:5

Cost-effectiveness of Aromatase Inhibitor Co-treatment for Controlled ovarian Stimulation IVF-ET in Patients with PCOS
原文传递
导出
摘要 目的:探讨来曲唑(LE)联合FSH在多囊卵巢综合征(PCOS)患者IVF-ET或ICSI中的应用及效价分析。方法:回顾性分析接受IVF-ET/ICSI治疗的170名PCOS不孕患者,分为LE组(LE-FSH组,n=59)与对照组(GnRHa-FSH组,n=111)。比较组间促排卵、妊娠结局、每周期治疗费用及药物效价比。结果:LE组和对照组FSH用药天数分别为6.3±1.9 d vs 13.0±2.3、用药量为615.6±284.6 IU vs l 504.9±424.9 IU,组间比较有显著性差异(P<0.01);hCG注射日E2值分别为1 965.3±1119.7 pmol/L vs 12 660.2±7 254.2 pmol/L,获卵数分别为6.5±3.3 vs16.6±7.9,组间比较均有显著性差异(P<0.01);受精率、胚胎种植率分别为66.1%vs71.6%,25.58%vs 23.63%,临床妊娠率为49.12%vs 34.48%,组间比较无显著性差异(P>0.05);中-重度OHSS发生率分别为O%和6.89%,组间比较差异有显著性(P<0.01)。LE组每刺激周期药费(2 877±1 240元)及每妊娠周期药费(3 014±1581元)显著低于对照组(6 561±1 852元、8774±1970元)(P<0.01),治疗效价比分别为5 959元vs 30 067元。结论:LE联合促卵泡素可有效运用于PCOS患者的IVF-ET中,较传统的GnRHa-FSH促排卵相比,无OHSS的发生、费用低、效价比高,且不影响妊娠率和种植率。 Objective: To explore the clinical results and the cost-effectiveness of using the aromatase inhibitor, letrozole (LE), in conjunction with FSH for controlled ovarian stimulation in patients with PCOS undergoing IVF-ET. Methods: A total of 170 infertile patients with PCOS who underwent IVF-ET/ICSI treatment were selected for the retrospective study. The patients were divided into two groups according to the treatments: letrozole-FSH group (LE group, n=59) and long GnRH agonist-FSH group (GnRHa group or control group, n=111). A retrospectively analysis was proformed between the two groups with dose of FSH used per cycle, the number of oocytes retrieved, fertilization rate, embryo implantation rate, clinical pregnancy rate and the occurrence of ovarian hyperstimulation syndrome (OHSS) and cost-effectiveness ratio per pregnancy. Results: Compared with control group, the LE group received a significantly lower total dose of FSH (615.6 ± 284.6 IU vs 1 504.9 ± 424.9 IU, P〈0.01) and had significantly decreased levels of terminal E2 (1 965.3 ±1119.7 pmol/L vs 12 660.2 ± 7 254.2 pmol/L, P〈0.01). Significantly less oocytes were retrieved (6.5 ± 3.3 vs 16.6 ± 7.9), but the fertilization rate (66.1% vs 71.6%), the implantation rate (25.58% vs 2 3.63%) and the clinical pregnancy rate (49.12% vs 34.48%) did not differ when compared with control group. The difference of the occurrence of OHSS was significant (0% vs 6.89%) between the two groups. The cost for per cycle and per pregnant cycle were significantly lower in the LE group compared with control group (2 877±1240 RMB vs 6 561 ±1 852 RMB, 3 014 ±1 581 RMB vs 8 774 ± 1 970 RMB, P〈0.01). The cost-effectiveness ratio was 5959 RMB in the letrozole group and 30 067 RMB in control group. Conclusion: A letrozole-FSH combination could be an effective ovarian stimulation protocol with PCOS patients in IVF/ICSI cycles. The incidence of OHSS can be controlled effectively. It is more cost-effective than long GnRH agonist/FSH protocol.
出处 《生殖与避孕》 CAS CSCD 北大核心 2009年第11期722-726,共5页 Reproduction and Contraception
关键词 来曲唑(LE) 多囊卵巢综合征(PCOS) IVF-ET 卵巢过度刺激综合征(OHSS) 效价比 letrozole (LE) polycystic ovarian syndrome (PCOS) IVF-ET ovarian hyperstimulation syndrome (OHSS) cost-effectiveness
  • 相关文献

参考文献11

  • 1Mitwally MF, Casper RF. Use of an aromatase inhitor for induction ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril, 2001,75 (2):305-9.
  • 2MitwaUy MF, Casper RF. Aromatase inhibition reduces the dose of gonadotropin required for controlled ovarian hyperstimulation. J Soc Gynecol Invest, 2004,11(61): 406-15.
  • 3Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod, 2004, 19(1):41-7.
  • 4Healey S, Tan SL, Tulandi T, et al. Effects of letrozole on superovulation with gonadotropins in women undergoing intrauterine insemination. Fertil Steril, 2003, 80 (6):1325-9.
  • 5Mitwally MF, Biljan MM, Casper RF. Pregnancy outcome after the use of an aromatase inhibitor for ovarian stimulation. Am Obstet Gynecol, 2005,192(2):381-6.
  • 6Goswami SK, Das T, Chattopadhyay R, et al. A randomized single--blind controlled trial of letrozole as a low-cost IVF protocol in women with poor ovarian response: a preliminary report. Hum Reprod, 2004,19(9):2031-5.
  • 7Verpoest WM, Kolibianakis E, Papanikolaou E, et al. Aromatase inhibitors in ovarian stimulation for IVF/ ICSI: a pilot study. Reprod Biomed Online, 2006, 13 (2): 166-72.
  • 8Noriega-Portella L, Noriega-Hoces L, Delgado A, et al. Effect of letrozole at 2.5 mg or 5.0 mg/day on ovarian stimulation with gonadotropins in women undergoing intrauterine insemination. Fertil Steril, 2008, 90(5): 1818-25.
  • 9Cortinez A, Carvalho ID, Vantman D, et al. Hormonal profile and endometrial morphology in letrozole-controlled ovarian hypestimulation in ovulatory infertile patients. Fertil Steril, 2005, 83(1):110-5.
  • 10章汉旺,李莉,李清,邓彧,段秀娟.来曲唑和克罗米酚对小鼠着床期子宫内膜容受性的影响[J].生殖与避孕,2007,27(4):251-254. 被引量:27

二级参考文献13

  • 1李莉,章汉旺.芳香酶抑制剂——来曲唑促排卵作用的研究进展[J].生殖与避孕,2006,26(8):486-490. 被引量:17
  • 2Mitwally MF,Casper R.The aromatase inhibitor,letrozole:a promising alternative for clomiphene citrate for induction of ovulation.Fertil Steril,2000,74(Suppl 1):S35.
  • 3Kilic-Okman T,Kucuk M,Altaner S.Comparison of the effects of letrozole and clomiphene citrate on ovarian follicles,endometrium,and hormone levels in the rat.Fertil Steril,2003,80(6):1 130-2.
  • 4A1-Fozan H,A1-Khadouri M,Tan SL,et al.A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation.Fertil Stefil,2004,82(6):1 561-3.
  • 5Holzer H,Casper R,Tulandi T.A new era in ovulation induction.Fertil Steril,2006,85(2):277-84.
  • 6Pierson RA.Imaging the endometrium:are there predictors uterine receptivity? J Gynaecol Can,2003,25(5):360-8.
  • 7Creus M,Ordi J,Fabregues F,et al.The effect of different hormone therapies on integrin expression and pinopode formation in the human endometrium:a controlled study.Hum Reprod,2003,18(4):683-93.
  • 8Cortinez A,de Carvalho I,Vantman D,et al.Hormonal profile and endometrial morphology in letrozole-controlled Ovarian hyperstimulation in ovulatory infertile patients.Fertil Steril,2005,83(1):110-5.
  • 9Mitwally MF,Casper R.Using aromatase inhibitors to induce ovulation in breast Ca survivors.Contemporary Ob/Gyn,2004,49(1):73-83.
  • 10Cullinan EB,Abbondanzo SJ,Anderson PS.Leukemia inhibitory factor (LIF) and LIF receptor expression in human endometrium suggests a potential autocrine/paracrin function in regulation embryo implantation.Proc Natl Acad Sci USA,1996,93(7):31 15-20.

共引文献26

同被引文献49

  • 1刘培,高玲霞,魏振年.联合用药治疗内分泌失调性不孕症的效果观察[J].中国计划生育学杂志,2006,14(9):558-559. 被引量:9
  • 2刘培,高玲霞.促排卵治疗中子宫内膜厚度与妊娠的关系临床探讨[J].江西医学院学报,2006,46(5):158-159. 被引量:6
  • 3GosWami SK, Das T, Chattopadhyay et al. A randomized single - blind controlled trial of letrozole as a low cost IVF protocol in women with poor ovarian response: a preliminary report[J]. Hum Reprod, 2004, 19 (9) : 2031.
  • 4Garcia- Velasco, Moreno L, Pacheco A et al. The aromatase inhibitor letrozole increase the concentration of intraovarian androgens and improves in vitro fertilization outcome in low responder patients: a pilot study [J] . Fertil Steril, 2005, 84 (1): 82.
  • 5May - Panloup P, Chretien MF, Jacques C et al. Low ooeyte mitoehondrial DNA content in ovarian insufficiency [J] . Hum Reprod, 2005, 20 (3) : 593.
  • 6Malmusi S, La Marca A, Giulini Set al. Comparison of a gonadotropin - releasing hormone (GnRH) antagonist and GnRH agonist flare - up regimen in poor responders undergoing ovarian stimulation[J].. Fertil Steril, 2005, 84 (2): 402.
  • 7Martin J, A1Fadhli R, Casper RF et al. Congenital malformations among 911 new borns conceived after infertility treatment with letrozole or clomiphene citrate [J] . Fertil Steril, 2006, 85 (6) : 1761.
  • 8Verpost WM, Kolibianakis E, Papanikolaou E et al. Aromatase inhibitors in ovarian stimulation for IVF/ICSI: a pilot study [ J] . Reprod Biomed Online, 2006, 13 (2): 166.
  • 9Weghofer A, Margreiter M, Bassim S et al. Minimal stimulation using recombinant follicle - stimulating hormone and a gonadotropin - releasing hormone antagonist in woman of advanced age [ J] . Fertil Steril, 2004, 81 (4): 1002.
  • 10吴效科.多囊卵巢综合征可能是原发性卵泡病[J].中国实用妇科与产科杂志,2007,23(9):660-663. 被引量:35

引证文献5

二级引证文献32

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部