Effect of Different Dosages of Letrozole on Hormonal Levels,Ovulation,Ovarian Ultrasound Characteristics and Pregnancy Outcomes in Obese Polycystic Ovary Syndrome Patients with Infertility
Objective:To explore the effects of different dosages of letrozole on hormonal levels,ovulation,ovarian ultrasound characteristics and pregnancy outcomes in obese polycystic ovary syndrome(PCOS)patients with infertility.Methods:A total of 138 obese PCOS patients with infertility treated in a hospital between March 2021 and March 2022 were selected and assigned to groups A,B and C by random number table method,with 46 patients in each group.All patients initiated treatment with letrozole tablets orally on the fifth day of their menstrual cycle,with dosages of 2.5mg/d,5mg/d,and 7.5mg/d for groups A,B,and C respectively,for five days.The effects of ovulation[maturity days of follicles,endometrial thickness on human chorionic gonadotropin(HCG)day,maximum follicle diameter,number of follicles≥18mm and≥15mm on HCG day)],ovarian ultrasound characteristics[total area(TA),2D ovarian volume(2D-OV),pulsatility index(PI),resistance index(RI)],estradiol(E2)levels on HCG injection day,occurrence of adverse reactions and pregnancy were compared among the three groups.Results:Following treatment,no statistically significant difference was observed in endometrial thickness on HCG day and maximum follicle diameter among the three groups(P>0.05).The maturation days of follicles were shorter in groups B and C compared to group A(P<0.05),with a higher count of follicles≥18mm and≥15mm on HCG day were higher in groups B and C than in group A(P<0.05),although no statistically significant difference was observed between groups B and C(P>0.05).TA,2D-OV and PI exhibited higher level in groups B and C compared to group A(P<0.05),and were higher in group C than those in group B(P<0.05);RI was lower than that in group A(P<0.05),and was lower in group C than that in group B(P<0.05).E2 levels on HCG injection day was higher in groups B and C compared to group A(P<0.05),with no statistically significant difference between groups B and C(P>0.05).No statistically significant difference was observed in adverse reactions during treatment across the groups(P>0.05).Similarly,no significant differences were noted in total pregnancy,biochemical pregnancy,clinical pregnancy,twin pregnancy and early miscarriage rates among the groups(P>0.05).Conclusion:In the treatment of obese PCOS patients with infertility,both 5mg/d and 7.5mg/d letrozole treatment can effectively promote follicle maturation,increase estrogen levels,improve ovarian ultrasonography and ovulation conditions,and promote ovulation.
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