生殖医学杂志2025，Vol.34Issue(6)：719-727,9.DOI:10.3969/j.issn.1004-3845.2025.06.001
来曲唑对生育力保存患者促排卵过程和妊娠结局的影响
The impact of letrozole on the ovulation induction process and pregnancy outcome in fertility preservation patients
摘要
Abstract
Objective:To investigate the effect of letrozole on ovulation induction and pregnancy outcomes in fertility preservation patients with malignant tumors. Methods:A total of 104 patients with malignant tumors who underwent assisted reproductive technology(ART)at the Reproductive Center of the First Affiliated Hospital of Nanjing Medical University from January 2010 to February 2024 were selected for fertility preservation.According to whether letrozole combined with recombinant gonadotropin(Gn)was used during ovarian stimulation,the patients were divided into letrozole group(69 cases)and non letrozole group(35 cases).The letrozole group was further divided into a high-dose group(5 mg/d,49 cases)and a low-dose group(2.5 mg/d,20 cases).The differences of laboratory outcomes and clinical pregnancy outcomes were compared between the two groups. Results:In the 104 patients who underwent both embryo cryopreservation and oocyte cryopreservation for fertility preservation,after adjusting for baseline estrogen(bE2)and anti-Müllerian hormone(bAMH)levels,patients in the letrozole group had significantly lower E2 levels on the HCG day and fewer follicles with a diameter of not less than 18 mm when compared with the non-letrozole group(P＜0.05).There were no significant differences in laboratory indicators between the high and low dose subgroups of 69 patients in the letrozole group(P＞0.05).Among the 84 patients who underwent embryo cryopreservation,the E2 level on HCG day in the letrozole group was significantly lower than that in the non letrozole group,while both LH and progesterone(P)levels on HCG day were significantly higher than those in the non letrozole group(P＜0.05).The cleavage rate and double primordial nuclei(2PN)fertilization rate of the letrozole group were significantly higher than those of the non letrozole group(P＜0.05).Among the 57 patients who underwent embryo cryopreservation and used letrozole,the body mass index(BMI)of the high-dose subgroup was significantly higher than that of the low-dose subgroup(P＜0.05).After adjusting for BMI,there were no significant differences in laboratory indicators between the two subgroups(P＞0.05).Among the patients with embryo cryopreservation,15 underwent transplantation after the embryos were thawed,and the bE2 level in the letrozole group was significantly higher than that in the non letrozole group(P＜0.05).After adjusting for the effect of bE2 level,there were no significant differences in pregnancy outcomes between the two groups(P＞0.05).Among the patients who underwent frozen thawed embryo transfer,11 patients who used letrozole to induce ovulation were further divided into a high-dose subgroup and a low-dose subgroup.There were no significant differences in baseline characteristics and pregnancy outcomes between the two subgroups(P＞0.05). Conclusions:The administration of letrozole in fertility preservation regimens for cancer patients has no significant adverse impact on pregnancy outcomes,although it may lead to the formation of smaller follicles.Furthermore,the dosage of letrozole does not significantly affect follicular development and pregnancy outcomes.关键词
生育力保存/来曲唑/控制性卵巢刺激/妊娠结局Key words
Fertility preservation/Letrozole/Controlled ovarian stimulation/Pregnancy outcomes分类
医药卫生引用本文复制引用
陶慧敏,刘嘉茵,徐嗣亮,张梦宇,鲁南,侯振,蔡令波,马翔,冒韵东,刁飞扬..来曲唑对生育力保存患者促排卵过程和妊娠结局的影响[J].生殖医学杂志,2025,34(6):719-727,9.基金项目
江苏省自然科学基金项目(BK20191491) （BK20191491）
生殖医学创新中心项目(CXZX202207) （CXZX202207）
