Comparison of embryological and clinical outcome in GnRH antagonist vs. GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study
Comparison of embryological and clinical outcome in GnRH antagonist vs. GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study
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DOI：
10.1007/s10815-008-9249-7
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发表时间：
2008-08-01
影响因子：
3.1
通讯作者：
Brelik, Pawel
中科院分区：
文献类型：
--
作者：
Kurzawa, Rafal;Ciepiela, Przemyslaw;Brelik, Pawel
目的比较促性腺激素释放激素（GnRH）拮抗剂和激动剂刺激治疗非肥胖女性多囊卵巢综合征（PCOS）的胚胎学和临床疗效。方法前瞻性随机研究。单位：医科大学附属医院。患者：不育性PCOS患者70例；GnRH拮抗剂组33例，激动剂组37例。结果两种方案的成熟中期卵母细胞率相似（76% vs. 76%）。最佳原核形态合子在两组中占主导地位（64%对66%）。移植胚胎的质量在两种方案中没有差异。两种方案在分娩率（p=0.481）、妊娠率（p=0.810）、多胎妊娠率（p=0.501）、流产率（p=0.154）、受精率（p=0.388）和着床率（p=1.000）方面差异无统计学意义。GnRH拮抗剂方案刺激时间和总促卵泡激素（FSH）剂量显著降低（p=0.0005）。结论GnRH拮抗剂和激动剂方案在非肥胖PCOS患者中产生相似的胚胎学和临床结果。GnRH拮抗剂组较短的治疗时间和较低的FSH需求可能在经济上有益，因此对患者有吸引力。
Purpose Embryological and clinical efficacy of gonadotropin-releasing hormone (GnRH) antagonist and agonist stimulation protocols in non-obese women with polycystic ovarian syndrome (PCOS) were compared.Methods A prospective randomized study. Setting: Medical University Hospital. Patients: 70 infertile PCOS patients; 33 in GnRH antagonist and 37 in GnRH agonist group.Results Similar mature metaphase II oocyte rate (76% vs. 76%) was observed in both protocols. Optimal pronuclear morphology zygotes dominated in both groups (64% vs. 66%). Transferred embryo quality did not differ in both protocols. No significant differences between both protocols were found in delivery rate (p=0.481), pregnancy rate (p=0.810), multiple pregnancy rate (p=0.501), miscarriage rate (p=0.154), fertilization rate (p=0.388) and implantation rate (p=1.000). Duration of stimulation and total follicle-stimulating hormone (FSH) dose were significantly lower in GnRH antagonist protocol (p=0.0005).Conclusions GnRH antagonist and agonist protocols in non-obese PCOS patients yield similar embryological and clinical outcomes. Shorter duration of treatment and lower FSH requirement in GnRH antagonist group may be financially beneficial and therefore attractive for patients.