Effect of GnRH agonist and letrozole treatment in women with recurrent implantation failure
Effect of GnRH agonist and letrozole treatment in women with recurrent implantation failure
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DOI：
10.1016/j.fertnstert.2019.03.021
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发表时间：
2019-07-01
影响因子：
6.7
通讯作者：
Dahan, Michael H.
中科院分区：
文献类型：
--
作者：
Steiner, Naama;Shrem, Guy;Dahan, Michael H.
目的：比较使用 GnRH 激动剂加芳香酶抑制剂的双重抑制与单独使用 GnRH 激动剂抑制或完全不抑制对特发性复发性着床失败 (RIF) 患者的影响。设计：回顾性队列研究。地点：大学附属生殖中心。患者：共有 523 名两次囊胚移植失败的不孕女性接受了第三次冷冻囊胚移植。已知患有子宫内膜异位症的女性被排除在外。 干预措施：总共 204 名受试者未经预处理，143 名受试者仅接受 2 个月的 GnRH 激动剂（每月 3.75 mg 肌肉注射醋酸亮丙瑞林），176 名受试者接受 GnRH 激动剂和芳香酶抑制剂（每天 5 mg 口服来曲唑，持续 60 天）。收集人口统计和刺激信息并报告周期结果。主要结果指标：临床妊娠率。结果：年龄、窦卵泡计数、基础 FSH 水平、不孕持续时间、既往妊娠和足月分娩相似 (P>.05)。与仅接受 GnRH 激动剂或未经预处理的女性相比，接受 GnRH 激动剂联合来曲唑治疗的女性临床妊娠率较高（分别为 63%、42% 和 40%；P
Objective: To compare the influence of dual suppression with the use of GnRH agonist plus aromatase inhibitor compared with suppression with the use of GnRH agonist alone or no suppression at all in patients with idiopathic recurrent implantation failure (RIF).Design: Retrospective cohort study.Setting: University-affiliated reproductive center.Patient(s): A total of 523 infertile women who failed two blastocyst transfers underwent a third frozen blastocyst transfer. Women with known endometriosis were excluded.Intervention(s): A total of 204 subjects were not pretreated, 143 received 2 months of GnRH agonist (3.75 mg intramuscular leuprolide acetate monthly) only, and 176 received GnRH agonist and aromatase inhibitor (5 mg oral letrozole daily for 60 days). Demographic and stimulation information was collected and cycle outcomes reported.Main Outcome Measure(s): Clinical pregnancy rates.Result(s): Age, antral follicle count, basal FSH levels, duration of infertility, previous pregnancies, and full-term deliveries were similar (P>.05). Clinical pregnancy rates were higher among women who received GnRH agonist plus letrozole compared with women who received GnRH agonist only or women without pretreatment (63%, 42%, and 40%, respectively; P