IS THE RETRIEVAL OF HIGH NUMBERS OF OOCYTES DESIRABLE IN PATIENTS TREATED WITH GONADOTROPIN-RELEASING HORMONE ANALOGS (GNRHA) AND GONADOTROPINS
IS THE RETRIEVAL OF HIGH NUMBERS OF OOCYTES DESIRABLE IN PATIENTS TREATED WITH GONADOTROPIN-RELEASING HORMONE ANALOGS (GNRHA) AND GONADOTROPINS
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DOI：
10.1093/oxfordjournals.humrep.a136940
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发表时间：
1989-07-01
影响因子：
6.1
通讯作者：
BONILLAMUSOLES, F
中科院分区：
文献类型：
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作者：
PELLICER, A;RUIZ, A;BONILLAMUSOLES, F
持续给予促性腺激素释放激素类似物（GnRHa）的患者刺激体外受精的目的可能对卵巢有直接影响。我们已经评估了使用Buserelin并随后联合使用促卵泡激素（FSH）和人类绝经期促性腺激素（HMG）的患者的体外受精结果。根据经阴道超声引导下卵泡抽吸获得的卵母细胞数量将患者分为三组：第一组（n = 35），取出1-5个卵母细胞；第二组（n = 30），获得6-10个卵母细胞；第三组（n = 32），其中。gtoreq。采集卵母细胞11个。只有在取卵时精液样本正常的夫妇才被纳入本研究。布赛林剂量组间无差异。然而，达到最佳反应所需的FSH/HMG含量随着卵泡发育的增加而显著降低（P < 0.01）。根据卵母细胞-冠-积云复合体的外观、受精率、胚胎的形态外观和着床率来评价获得的卵母细胞的质量。3组受精率（57.2%）极显著（P < 0.01）低于1组（77.1%）和2组（74.2%）。各组之间获得的胚胎质量和植入子宫的胚胎质量没有显著差异。每移植胚胎着床率1组（16.5%）显著高于2组（6.6%）和3组（8.2%）（P < 0.05）。每名患者的妊娠率分别为22.9%、23.3%和25.0% (NS)，尽管第2组每名患者的胚胎替换数量显著（P < 0.001）增加(3.7 .+-。0.2)和3(3.8 .+-。与第1组(2.3 .+-。0.2)。这些数据表明，在接受GnRHa治疗的女性中，获得数量较多的卵母细胞与质量较低的卵母细胞相关。这表现为受精率下降以及胚胎植入子宫的低着床率。
Continuous administration of gonadotrophin-releasing hormone analogues (GnRHa) in patients stimulated for the purpose of IVF might have a direct effect on the ovary. We have evaluated the IVF outcome of patients treated with Buserelin and subsequently with a combination of follicle-stimulating hormone (FSH) and human menopausal gonadotrophin (HMG). Patients were divided into three groups according to the number of oocytes obtained by transvaginal ultrasound-guided follicular aspiration: group 1 (n = 35), in which 1-5 oocytes were retrieved; group 2 (n = 30), in whom 6-10 oocytes were obtained; group 3 (n = 32), in whom .gtoreq. 11 oocytes were collected. Only couples with normal semen samples at oocyte retrieval were included in this study. The dose of Buserelin employed was not different between groups. However, the amount of FSH/HMG necessary to reach an optimal response significantly (P < 0.01) decreased as follicular development increased. The quality of the oocytes obtained was evaluated based on the appearance of the oocyte-corona-cumulus complex, fertilization rate, morphological appearance of the embryos, and implantation rate. The fertilization rate was significantly (P < 0.01) decreased in group 3 (57.2%) in comparison with groups 1 (77.1%) and 2 (74.2%). There was no significant difference between groups in the quality of the embryos obtained or the quality of those replaced into the uterus. The implantation rate per embryo transferred was significantly (P < 0.05) higher in group 1 (16.5%) in comparison with groups 2 (6.6%) and 3 (8.2%). Pregnancy rates per patient were 22.9, 23.3 and 25.0% respectively (NS), despite a significant (P < 0.001) increase in the number of embryos replaced per patient in groups 2 (3.7 .+-. 0.2), and 3 (3.8 .+-. 0.3) compared with group 1 (2.3 .+-. 0.2). These data suggest that the retrieval of higher of numbers oocytes in women treated with GnRHa is correlated with oocytes of lower quality. This is manisfested by a decreased fertilization rate as well as a lower implantation rate of the embryos replaced into the uterus.