GnRH antagonists in ovarian stimulation: a treatment regimen of clinicians' second choice? Data from the German national IVF registry
GnRH antagonists in ovarian stimulation: a treatment regimen of clinicians' second choice? Data from the German national IVF registry
复制标题
DOI：
10.1093/humrep/dei086
复制
发表时间：
2005-09-01
影响因子：
6.1
通讯作者：
Diedrich, K
中科院分区：
文献类型：
--
作者：
Griesinger, G;Felberbaum, R;Diedrich, K
GnRH拮抗剂在卵巢刺激中的地位是有争议的。比较GnRH激动剂和GnRH拮抗剂治疗方案的研究荟萃分析表明，GnRH拮抗剂的疗效相对较低，这可能影响了临床医生的态度。本报告描述了2000-2003年德国GnRH拮抗剂用于卵巢刺激的情况。分析了国家试管婴儿登记处的数据。尽管GnRH拮抗剂的使用显著增加（P < 0.0001），但大多数卵巢刺激周期仍在长期GnRH激动剂方案中进行。两项观察结果支持GnRH拮抗剂通常在先验预后不利的周期中用作治疗选择的观点：(i) GnRH拮抗剂周期的比例随着周期等级的增加而增加（P < 0.0001, chi(2)为线性趋势）；（ii）与GnRH激动剂周期相比，老年患者更常使用GnRH拮抗剂周期（P < 0.0001）。这对于在研究背景之外解释GnRH拮抗剂的临床表现具有重要意义。
The place of GnRH antagonists in ovarian stimulation is controversial. Meta- analyses on studies comparing GnRH agonist and GnRH antagonist treatment regimens have suggested a comparatively lower efficacy of GnRH antagonists, which is likely to have influenced clinicians' attitudes. This report describes GnRH antagonist utilization for ovarian stimulation in Germany from 2000-2003. Data from the national IVF registry were analysed. The majority of ovarian stimulation cycles are still performed in long GnRH agonist protocols, although a significant increase in GnRH antagonist usage has been noted (P < 0.0001). Two observations support the notion that GnRH antagonists are often utilized as a treatment option in cycles with an unfavourable a priori prognosis: (i) the proportion of GnRH antagonist cycles increases with cycle rank (P < 0.0001, chi(2) for linear trend); and (ii) GnRH antagonist cycles are more often conducted in older patients as compared to GnRH agonist cycles (P < 0.0001). This has important implications for interpreting clinical performance of GnRH antagonists outside a research context.