克罗米酚和抗雌激素药物排卵在PCOS感应。
文章的细节
-
引用
复制到剪贴板 -
布斯罗伊德布朗J,法夸尔C,贝克J, C,休斯E
克罗米酚和抗雌激素药物排卵在PCOS感应。
科克伦数据库系统启2009 10月7;(4):CD002249。cd002249.pub4 doi: 10.1002/14651858.。
- PubMed ID
-
19821295 (在PubMed]
- 文摘
-
背景:Subfertility由于停止排卵是女性的一个常见问题。一线口服治疗与抗雌激素药物,例如克罗米酚柠檬酸盐,但是阻力(未能排卵)可能与克罗米酚明显。替代和辅助治疗方法被开发出来如他莫昔芬、地塞米松、溴麦角环肽。目的:确定的相对有效性抗雌激素单独或结合其他医学治疗女性subfertility停止排卵,可能由于多囊性卵巢综合征(PCOS)。搜索策略:进行搜索使用Cochrane月经失调和Subfertility组试验注册(2009年5月),中央(Cochrane图书馆2009年,问题2),MEDLINE(1966年至2009年5月),和EMBASE(1980年至2009年5月)识别相关的随机对照试验(相关的)。英国国家临床优化研究所(NICE)准则和相关评论和引用相关的搜索。选择标准:相关比较口服抗雌激素诱导排卵(单独或结合医学疗法)阻止排卵的subfertility被认为是。胰岛素感光剂、芳香化酶抑制剂和hyperprolactinaemic不育被排除在外。数据收集和分析:数据提取和质量评估是由两个评论作者独立完成。主要结果是活产; secondary outcomes were pregnancy, ovulation, miscarriage, multiple pregnancy, overstimulation, ovarian hyperstimulation syndrome, and women reported adverse effects. MAIN RESULTS: This is a substantive update of a previous review. Fifteen RCTs were included. One trial reported live birth. Miscarriage, multiple pregnancy rates and adverse events were poorly reported.Clomiphene was effective in increasing pregnancy rate compared to placebo (OR 5.8, 95% CI 1.6 to 21.5) as was clomiphene plus dexamethasone treatment (OR 9.46, 95% CI 5.1 to 17.7) compared to clomiphene alone. No evidence of a difference in effect was found between clomiphene versus tamoxifen or clomiphene in conjunction with human chorionic gonadotrophin (hCG) versus clomiphene alone.The remaining results had only one study in each comparison. A significant improvement in the pregnancy rate was reported for clomiphene plus combined oral contraceptives versus clomiphene alone. No evidence of a difference in effect on pregnancy rate was found with any of the other comparisons. AUTHORS' CONCLUSIONS: This review shows evidence supporting the effectiveness of clomiphene citrate and clomiphene in combination with dexamethasone for pregnancy rate only. There is limited evidence on the effects of these drugs on outcomes such as miscarriage. Evidence in favour of these interventions is flawed due to the lack of evidence on live births.