张巧利;贾婵维;马延敏;王树玉;

• 1:首都医科大学附属北京妇产医院生殖医学科

摘要(Abstract)：

克罗米芬是第一个用于临床的促排卵药物,具有里程碑式的意义,但由于一些副作用限制了其应用。人们尝试采用芳香化酶抑制剂来曲唑进行促排卵,目前已形成了较成熟的促排卵经验。本文将从两者的促排卵作用机制、特点和用药方案等方面进行综述。

关键词(KeyWords)： 克罗米芬;来曲唑;不孕;促排卵;妊娠结局

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(No:81302441)

作者(Authors): 张巧利;贾婵维;马延敏;王树玉;

DOI: 10.13283/j.cnki.xdfckjz.2016.01.018

参考文献(References)：

• [1]Revelli A,Casano S,Salvagno F,et al.Milder is better?Advantages and disadvantages of"mild"ovarian stimulation for human in vitro fertilization[J].Reprod Biol Endocrinol,2011,16(9):25
• [2]Wallace KL,Johnson V,Sopelak V,et al.Clomiphene citrate versus letrozole:molecular analysis of the endometrium in women with polycystic ovary syndrome[J].Fertil Steril,2011,96(4):1051-1056
• [3]Homburg R.Clomiphene citrate-end of an era?A minireview[J].Hum Reprod,2005,20(8):2043-2051
• [4]Al-Fozan H,Al-Khadouri M,Tan SL,Tulandi T.A randomized trial of letrozole versus clomiphene citrate in women undergoing superovulation[J].Fertil Steril,2004,82(6):1561-1563
• [5]Cortinez A,De Carvalho I,Vantman D,et al.Hormonal profile and endometrial morphology in letrozole-controlled ovarian hyperstimulation in ovulatory infertile patients[J].Fertil Steril,2005,83(1):110-115
• [6]Baruah J,Roy KK,Rahman SM,et al.Endometrial effects of letrozole and clomiphene citrate in women with polycystic ovary syndrome using spiral artery Doppler[J].Arch Gynecol Obstet,2009,279(3):311-314
• [7]Eftekhar M,Mohammadian F,Davar R,et al.Comparison of pregnancy outcome after letrozole versus clomiphene treatment for mild ovarian stimulation protocol in poor responders[J].Iran J Reprod Med,2014,12(11):725-730
• [8]Liu A1,Zheng C,Lang J,et al.Letrozole versus clomiphene citrate for unexplained infertility:a systematic review and meta-analysis[J].J Obstet Gynaecol Res,2014,40(5):1205-1216
• [9]Bayar U,Tanriverdi HA,Barut A,et al.Letrozole vs.clomiphene citrate in patients with ovulatory infertility[J].Fertil steril,2006,85(4):1045-1048
• [10]The Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group.Consensus on infertility treatment related to polycystic ovary syndrome[J].Hum Reprod,2008,23(3):462-477
• [11]Hughes E,Brown J,Collins JJ,et al.Clomiphene citrate for unexplained subfertility in women[J].Cochrane Database Syst Rev,2010,20,(1):CD000057
• [12]Wordsworth S,Buchanan J,Mollison J,et al.Clomifene citrate and intrauterine insemination as first-line treatments for unexplained infertility:are they cost-effective?[J].Hum Reprod,2011,26(2):369-375
• [13]Pritts EA.Letrozole for ovulation induction and controlled ovarian hyperstimulation[J].Curr Opin Obstet Gynecol,2010,22(4):289-294
• [14]Malloch L,Rhoton-Vlasak A.An assessment of current clinical attitudes toward letrozole use in reproductive endocrinology practices[J].Fertil Steril,2013,100(6):1740-1744
• [15]El-Gharib MN,Mahfouz AE,Farahat MA.Comparison of letrozole versus tamoxifen effects in clomiphen citrate resistant women with polycystic ovarian syndrome[J].J Reprod Infertil,2015,16(1):30-35
• [16]Ghomian N,Khosravi A,Mousavifar N.A randomized clinical trial on comparing the cycle characteristics of two different initiation days of letrozole treatment in clomiphene citrate resistant PCOS patients in IUI cycles[J].Int J Fertil Steril,2015,9(1):17-26
• [17]Roy KK,Baruah J,Singla S,et al.A prospective randomized trial comparing the efficacy of letrozole and clomiphene citrate in induction of ovulation in polycystic ovarian syndrome[J].J Hum Reprod Sci,2012,5(1):20-25
• [18]Fouda UM,Sayed AM.Extended letrozole regimen versus clomiphene citrate for superovulation in patients with unexplained infertility undergoing intrauterine insemination:a randomized controlled trial[J].Reprod Biol Endocrinol,2011,9:84
• [19]Begum MR,Ferdous J,Begum A,et al.Comparison of efficacy of aromatase inhibitor and clomiphene citrate in induction of ovulation in polycystic ovarian syndrome[J].Fertil Steril,2009,92(3):853-857
• [20]Franik S,Kremer JA,Nelen WL,et al.Aromatase inhibitors for subfertile women with polycystic ovary syndrome[J].Cochrane Database Syst Rev,2014,24,(2):CD010287
• [21]Badawy A,Abdel Aal AI,Abulatta M.Clomiphene citrate or letrozole for ovulation induction in women with polycystic ovarian syndrome:A prospective randomized trial[J].Fertil Steril,2009,92(3):849-852
• [22]Ibrahim MI,Moustafa RA,Abdel-Azeem AA.Letrozole versus clomiphene citrate for superovulation in Egyptian women with unexplained infertility:a randomized controlled trial[J].Arch Gynecol Obstet,2012,286(6):1581-1587
• [23]莫有敏,杨菁.二甲双胍联合克罗米芬治疗多囊卵巢综合征有效性的Meta分析[J].武汉大学学报(医学报),2013,34(1):99-104
• [24]Abu Hashim H,Foda O,Ghayaty E.Combined metformin-clomiphene in clomiphene-resistant polycystic ovary syndrome:a systematic review and meta-analysis of randomized controlled trials[J].Acta Obstet Gynecol Scand,2015[Epub ahead of print]
• [25]傅薇,李路,董曦,等.克罗米芬对卵巢储备功能减退患者进行促排卵治疗的有效性研究[J].生殖与避孕,2013,33(5):347-350
• [26]Oride A,Kanasaki H,Miyazaki K.Comparison of human menopausal gonadotropin stimulation with and without clomiphene for in-vitro fertilisation in poor-responders[J].J Obstet Gynaecol,2015,35(2):163-167
• [27]Jovanovic VP,Kort DH,Guarnaccia MM,et al.Does the addition of clomiphene citrate or letrazole to gonadotropin treatment enhance the oocyte yield in poorresponders undergoing IVF[J]?J Assist Reprod Genet,2011,28(11):1067-1072
• [28]Ferraretti AP,Gianaroli L,Magli MC,et al.Mild ovarian stimulation with clomiphene citrate launch is a realistic option for in vitro fertilization[J].Fertil Steril,2015[Epub ahead of print]
• [29]Rashidi M,Aaleyasin A,Aghahosseini M,et al.Advantages of recombinant follicle-stimulating hormone over human menopausal gonadotropin for ovarian stimulation in intrauterine insemination:a randomized clinical trial in unexplained infertility[J].Eur J Obstet Gynecol Reprod Biol,2013,169(2):244-247
• [30]Lee KH,Kim CH,Suk HJ,et al.The effect of aromatase inhibitor letrozole incorporated in gonadotrophin-releasing hormone antagonist multiple dose protocol in poor responders undergoing in vitro fertilization[J].Obstet Gynecol Sci,2014,57(3):216-222
• [31]Mitwally MF,Casper RF.Aromatase inhibitor improves ovarian response to follicle-stimulating hormone in poor responders[J].Fertil Steril,2002,77(4):776-780
• [32]Akbari S,Ayazi Roozbahani M,Ayazi Roozbahani F.Comparing of letrozole versus clomiphene citrate combined with gonadotropins in intrauterine insemination cycles[J].Iran J Reprod Med,2012,10(1):29-32
• [33]Hajishafiha M,Dehghan M,Kiarang N,et al.Combined letrozole and clomiphene versus letrozole and clomiphene alone in infertile patients with polycystic ovary syndrome[J].Drug Des Devel Ther,2013,7:1427-1431