Exogenous luteinizing hormone in controlled ovarian hyperstimulation for assisted reproduction techniques
Exogenous luteinizing hormone in controlled ovarian hyperstimulation for assisted reproduction techniques
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DOI：
10.1016/j.fertnstert.2004.06.041
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发表时间：
2004-12-01
影响因子：
6.7
通讯作者：
Montanaro, N
中科院分区：
文献类型：
--
作者：
Ferraretti, AP;Gianaroli, L;Montanaro, N
目的：为探讨外源性促性腺激素（LH）在控制性超促排卵中的作用，采用前瞻性随机对照研究方法，将在促性腺激素释放激素（GnRH）下调下对FSH低反应的妇女随机分为3组：A组（n = 54），增加FSH剂量; B组（n = 54）在增加FSH剂量的基础上加用重组LH，C组（n = 22）在增加FSH和LH的基础上加用hMG。54例年龄匹配的无需增加FSH剂量的妇女作为对照组（D）。干预措施：无。主要结局指标：每个开始周期的着床率和活产率。结果：与A组和C组相比，B组的妊娠率和着床率在统计学上较高，与正常反应的对照组相比无差异。B组和D组的活产率相似，但A组和C组的活产率为A组和C组的一半。结论：对FSH的低反应性可能与医源性LH缺乏有关，医源性LH缺乏反过来会影响卵母细胞的能力。添加少量重组LH能够挽救卵母细胞产生可存活胚胎的能力。(C)2004年，美国生殖医学会。
Objective: To investigate the role of exogenous LH in controlled ovarian hyperstimulation for assisted reproductive technologies.Design: Prospective randomized study.Setting: SISMER fertility unit.Patient(s): Women showing a hyporesponsiveness to FSH under GnRH agoinst down-regulation were randomized into three groups: group A (n = 54) received an increased dosage of FSH; group B (n = 54) was administered recombinant LH in addition to the increased dose of FSH; group C (n = 22) was given additional FSH and LH using hMG as a combined drug. Fifty-four age-matched women with no need to increase the FSH dose were included as a control group (D).Intervention(s): None.Main Outcome Measure(s): Implantation and live birth rate per started cycles.Result(s): In group B, the pregnancy and implantation rates were statistically higher when compared with groups A and C and did not differ from the control group for normal response. The live birth rate was similar in groups B and D but was half as high in groups A and C.Conclusion(s): Hyporesponsiveness to FSH could be related to iatrogenic LH deficiency that, in turn, could affect oocyte competence. Addition of a small amount of recombinant LH is able to rescue oocyte competence to produce viable embryos. (C) 2004 by American Society for Reproductive Medicine.