芳香環轉化酶抑制劑之誘發排卵

Aromatase Inhibitors for Ovulation Induction

詹景全(Chying-Chyuan Chan) ； 金承惠(Chen-Hui Jin) ； 武國璋(Gwo-Jang Wu) ； 鍾明宗(Ming-Tzeung Chung) ； 彭忠衎(Chung-Kan Peng)

《北市醫學雜誌》 3卷11期 (2006/11) Pp. 10-17

https://doi.org/10.6200/TCMJ.2006.3.11.02

摘要

誘導排卵及引卵治療是不孕症治療時最常使用的方法。我們則希望藉由引卵的方式來獲得更多可用的卵子。卵巢刺激可以使用外生性的性腺刺激素直接刺激卵巢，或以口服排卵藥Clomiphene Citrate增加內生性濾泡促進素，來達到刺激排卵的目的。在過去的40年，C.C一直都是第一線的誘導排卵用藥。C.C有著容易使用（以口服方式）及對大部分的人(60%~70%)都有治療效果。但是使用C.C的懷孕率卻是讓人失望的只有10%~40%。性腺刺激素較C.C誘導排卵的效果好很多。可是除了性腺刺激素比C.C貴很多，另一方面使用性腺刺激素誘導排卵也比使用C.C增加很多卵巢過度刺激症候群(OHSS)及多胞胎懷孕的機會。由於對C.C引卵效果的失望，及對性腺刺激素過於昂貴又多併發症的結果，很多的不孕醫師，都在尋找一種容易使用、便宜又有效的藥。本文就是在探討運用芳香環轉化酵素抑制劑來誘導排卵是否就是讓人期待的新配方。

關鍵字

誘導排卵 ； 口服排卵藥 ； 芳香環轉化酵素抑制劑 ； 性腺刺激素

並列摘要

Ovulation induction and superovulation are the most popular medical solutions for the treatment of infertility. The mechanism involves obtaining more and more usable follicles by a method that induces ovulation. This can be done by stimulating the ovaries in two different ways; firstly, using external gonadotropins that directly act on the ovary or secondly, by increasing the internal levels of folliclestimulating hormone using the oral ovulation medicine Clomiphene Citrate (CC). Over the past four decades, CC has been the most popular approach to inducing ovulation. It is easy to use, oral and the treatment is effective for most patients (60%~70%). However, the pregnancy rate using CC is disappointing and only ranges from 10% to 40%. In contrast, the effect on ovulation of using gonadotropins is much stronger than with CC, but gonadotropin treatment is much more expensive than CC. Furthermore, the use of gonadotropins has a higher risk than the use of CC when inducing ovulation because the approach is associated with a higher frequency of ovarian hyperstimulation syndrome (OHSS) and multiple gestations. The poorer results of CC treatment and the higher cost of gonadotropins treatment, as well as the latter's link to OHSS complications, has led to fertility care providers searching for new medical approaches that are easy to use, inexpensive and more effective than CC. In this review, we will discuss the use of a new group of medicines, the ”aromatase inhibitors”, which may be useful as ovulation inducers.

並列關鍵字

ovulation induction ； clomiphene citrate ； aromatase inhibitor ； gonadotropin