Circulating luteinizing hormone level after triggering oocyte maturation with GnRH agonist may predict oocyte yield in flexible GnRH antagonist protocol
Circulating luteinizing hormone level after triggering oocyte maturation with GnRH agonist may predict oocyte yield in flexible GnRH antagonist protocol
复制标题
用 GnRH 激动剂触发卵母细胞成熟后的循环黄体生成素水平可以预测灵活的 GnRH 拮抗剂方案中的卵母细胞产量
DOI：
10.1093/humrep/des049
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发表时间：
2012-05-01
影响因子：
6.1
通讯作者：
Guo, Wei
中科院分区：
文献类型：
--
作者：
Chen, Shi-Ling;Ye, De-Sheng;Guo, Wei
使用促性腺激素释放激素 (GnRH) 激动剂触发最终卵母细胞成熟和排卵可以减少高危患者的卵巢过度刺激综合征 (OHSS)。 GnRH 激动剂触发后的 LH 水平可能与卵母细胞产量和成熟度相关。我们的目的是评估 OHSS 高风险患者在触发后 12 小时的血清 LH 水平与卵母细胞产量、成熟度和受精率之间的关系，这些患者接受灵活的 GnRH 拮抗剂方案治疗，其中用 GnRH 激动剂触发最终卵母细胞成熟。 在一项前瞻性队列研究中，91 名 OHSS 高风险患者接受灵活的 GnRH 拮抗剂方案治疗，并根据其血清 LH 水平分为六组GnRH激动剂给药后12小时：15.0、15.130.0、30.145.0、45.160.0、60.175.0和75.0 IU/l。分析各LH间隔的卵母细胞产量、成熟度、受精率和临床结果。血清LH浓度为15.0 IU/l时，卵母细胞产量显着降低（P〈0.05），而六组间卵母细胞成熟度和受精率差异无统计学意义（P〈0.05）。在 GnRH 激动剂触发后 12 小时，91 名患者中只有 5 名 (5.5) 的血清 LH 为 15.0 IU/l。此外，LH 15.0 IU/l 和 15.0 IU/l 患者在高质量胚胎、着床率、临床妊娠率和早期流产方面没有显着差异（P < 0.05）。 GnRHa 15.0 IU/l 触发后 12 小时血清 LH 水平与卵母细胞产量显着降低相关，但与卵母细胞成熟度和受精率无关。 GnRH 激动剂触发后的血清 LH 水平不会影响临床结果。
The use of gonadotrophin-releasing hormone (GnRH) agonist for triggering final oocyte maturation and ovulation can reduce ovarian hyperstimulation syndrome (OHSS) in high-risk patients. LH levels post-trigger with GnRH agonist might be correlated with oocyte yield and maturity. Our aim was to evaluate the relationship between serum LH level at 12-h post-trigger and oocyte yield, maturity and fertilization rate in patients at high risk of OHSS and therefore who were treated with a flexible GnRH antagonist protocol in which final oocyte maturation was triggered with GnRH agonist.In a prospective cohort study, 91 patients at high risk of OHSS were treated with a flexible GnRH antagonist protocol and divided into six groups according to their serum LH levels at 12-h after GnRH agonist administration: 15.0, 15.130.0, 30.145.0, 45.160.0, 60.175.0 and 75.0 IU/l. The oocyte yield, maturity, fertilization rate and clinical outcomes for each LH interval were analyzed.There was a statistically significant reduction in oocyte yield with a concentration of serum LH 15.0 IU/l (P 0.05), whereas no statistically significant differences in the oocyte maturity and fertilization rate among the six groups (P 0.05) were seen. Only 5 out of 91 patients (5.5) had a serum LH 15.0 IU/l at 12-h post-trigger with GnRH agonist. In addition, no statistically significant difference was seen regarding high-quality embryos, implantation rate, clinical pregnancy rate and early miscarriage between patients with LH 15.0 IU/l and 15.0 IU/l (P 0.05).Serum LH level at 12-h post-trigger with GnRHa 15.0 IU/l is associated with a dramatically lower oocyte yield but not with the oocyte maturity and fertilization rate. Serum LH levels post-trigger with GnRH agonist do not affect clinical outcomes.