Comparison of two oral ovulation induction medicines infertile women treatment

• Main Author: 黃千惠
• Other Authors: 王妙媛
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/79615835459094083899

碩士 === 國立彰化師範大學 === 生物技術研究所 === 95 === In this study, we evaluated and compared the ovulation stimulation by anastrozole and clomiphene citrate in women with infertility. A total of 33 infertile patients were enrolled, ages 25-41 years. Patients received either anastrozole 1 mg daily or clomiphene citrate 100 mg daily from cycle day 3 to day 7. Number of mature follicles (≧ 18 mm), endometrial thickness, and pregnancy rate were measured. Blood samples were taken on cycle day 3, day 8, day 10, AIH day, post-AIH day 7 (day 21), and post-AIH day 14 (day 28) for serial hormonal profiles (FSH, LH, E2, T, and P4) and gene expression analyses of CYP19 and SPP1 using real-time PCR. The basic parameters were similar in two groups, including age, BMI, infertility duration and day 3 serum hormones expect FSH. The mean FSH value on day 3 was significantly different (4.3 mIU/mL in the AI group to 6.3 mIU/mL in the CC group; p＜0.05 ). The anastrozole group had a fewer number of ovulatory follicles (1.2 in the AI group to 1.8 in the CC group; p＜0.05) with a thicker endometrium (10.6 in the AI group to 7.8 mm in the CC group; p＜ 0.05 ). The level of progesterone and testosterone were similar during ovulation stimulation cycle in both groups. On the other hand, the anastrozole group has a significantly higher LH level, but a significantly lower estradiol level in the stimulation cycle. The result of molecular level showed that CYP19 expression were significantly 11 folds lower in AI group than CC group. In addition, SPP1 did not express in infertile women, but in normal control. It indicates that SPP1 may be an important factor contributing to uterine receptivity possibly by interaction with αvb3 integrin and/or other extracellular matrix proteins. Anastrozole has high pregnant rate, though it induces less ovulatory follicles when comparing with clomiphene citrate. The effects of both drugs gave different response of FSH, LH and estradiol during stimulation.