Alternate day and daily administration of GnRH antagonist may prevent premature luteinization to a similar extent during FSH treatment
Alternate day and daily administration of GnRH antagonist may prevent premature luteinization to a similar extent during FSH treatment
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DOI：
10.1093/humrep/dei210
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发表时间：
2005-11-01
影响因子：
6.1
通讯作者：
Milingos, S
中科院分区：
文献类型：
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作者：
Messinis, IE;Loutradis, D;Milingos, S
背景技术背景：这项随机对照试验旨在评估每隔一天给予一次GnRH拮抗剂是否可以预防接受IVF/ICSI治疗的女性过早黄体化。方法：共有73名接受重组FSH促排卵IVF周期的女性在周期第7天随机分配至GnRH拮抗剂ganirelix多次给药（每次0.25 mg），每日（n = 37名女性，组1）或每隔一天（n = 36名女性，组2），直至HCG给药日。结果：两组血清FSH、LH、雌二醇和孕酮的变化趋势相似。在FSH刺激期间，第1组中有13名（35%）女性出现过早LH升高（>= 10 IU/l），其中8名（22%）发生在开始拮抗剂给药后。在第2组中，FSH刺激期间有14例（39%）LH升高，其中10例（28%）发生在拮抗剂给药开始后。各组中仅有1名妇女发生了黄体化（血清孕酮> 2 ng/ml）（3%）。第2组中使用的拮抗剂的总剂量显著小于第1组（P < 0.001）。该研究没有能力评估FSH总剂量、回收的卵母细胞数量和临床妊娠率的差异，所有这些在两组中似乎相似。结论：隔日给药是否与每日给药加尼瑞克一样有效预防过早黄素化，应在评估活产率的非劣效性试验中进行研究。
BACKGROUND: This randomized controlled trial was designed to evaluate whether a GnRH antagonist given every other day could prevent premature luteinization in women undergoing IVF/ICSI treatment. METHODS: A total of 73 women receiving ovulation stimulation IVF cycles with recombinant FSH were allocated randomly on cycle day 7 to GnRH antagonist ganirelix in multiple doses (0.25 mg each), either daily (n = 37 women, group 1) or every other day (n = 36 women, group 2) until the day of HCG administration. RESULTS: Serum FSH, LH, estradiol and progesterone values showed similar trends in the two groups. During FSH stimulation, 13 (35%) of the women in group 1 had premature LH rises (>= 10 IU/l) of which eight (22%) were after the start of antagonist administration. In group 2 there were 14 (39%) LH rises during FSH stimulation of which 10 (28%) were after the start of antagonist administration. Luteinization (serum progesterone > 2 ng/ml) occurred in only one woman in each group overall (3%). A significantly smaller total dose of the antagonist was used in group 2 than in group 1 (P < 0.001). The study did not have power to evaluate differences in total dose of FSH, number of oocytes recovered and clinical pregnancy rate, all of which appeared similar in the two groups. CONCLUSIONS: Whether alternate day is as effective as daily administration of ganirelix in preventing premature luteinization should be addressed in a non-inferiority trial powered to evaluate live birth rate.