GnRH agonist versus GnRH antagonist in oocyte donation cycles: a prospective randomized study
GnRH agonist versus GnRH antagonist in oocyte donation cycles: a prospective randomized study
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DOI：
10.1093/humrep/deh832
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发表时间：
2005-06-01
影响因子：
6.1
通讯作者：
Makedos, G
中科院分区：
文献类型：
--
作者：
Prapas, N;Prapas, Y;Makedos, G
背景：LH在卵泡发生和卵母细胞成熟中的具体作用尚不清楚。促性腺激素释放激素拮抗剂，当在卵泡晚期给药时，诱导血清LH急剧下降，这可能对IVF结局不利。本研究旨在评价在卵母细胞捐献周期中用GnRH拮抗剂（ganirelix; NV Organon）替代GnRH激动剂（曲普瑞林）是否对妊娠率和着床率有任何影响。方法：共148个供体IVF周期被随机分配到使用GnRH拮抗剂，每天从刺激的第8天（组I）或GnRH激动剂长方案（组II），用于其供体的卵巢刺激。主要终点是妊娠率和着床率。研究结果：根据妊娠7周经阴道扫描结果，两组的每次移植临床妊娠率（39.72%，29/73 vs 41.33%，31/75）、种植率（23.9% vs 25.4%）和早期妊娠流产率（10.34% vs 12.90%）相似。结论：在卵母细胞捐献周期中，当在刺激第8天开始给药时，用GnRH拮抗剂替代GnRH激动剂似乎对妊娠率和着床率没有影响。
BACKGROUND: The specific role of LH in folliculogenesis and oocyte maturation is unclear. GnRH antagonists, when administered in the late follicular phase, induce a sharp decrease in serum LH which may be detrimental for IVF outcome. This study was performed to evaluate whether the replacement of GnRH agonist (triptorelin) by a GnRH antagonist (ganirelix; NV Organon) in oocyte donation cycles has any impact on pregnancy and implantation rates. METHODS: A total of 148 donor IVF cycles was randomly assigned to use either a GnRH antagonist daily administered from the 8th day of stimulation (group I) or a GnRH agonist long protocol (group II) for the ovarian stimulation of their donors. The primary endpoints were the pregnancy and the implantation rates. RESULTS: The clinical pregnancy rate per transfer (39.72%, 29/73 versus 41.33%, 31/75) based on transvaginal scan findings at 7 weeks of gestation, the implantation rate (23.9 versus 25.4%) and the first trimester abortion rate (10.34 versus 12.90%) were similar in the two groups. CONCLUSION: In oocyte donation cycles the replacement of GnRH agonist by a GnRH antagonist appears to have no impact on the pregnancy and implantation rates when its administration starts on day 8 of stimulation.