Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles
Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles
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DOI：
10.1093/humrep/del173
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发表时间：
2006-10-01
影响因子：
6.1
通讯作者：
Mendoza, Carmen
中科院分区：
文献类型：
--
作者：
Tesarik, Jan;Hazout, Andre;Mendoza, Carmen
背景：GnRH激动剂最近被认为是一种新的黄体期支持剂，可能在不同水平起作用，包括垂体促性腺激素、子宫内膜和胚胎本身。这项前瞻性随机研究评估了在黄体期使用GnRH激动剂和GnRH拮抗剂治疗卵巢刺激方案对ICSI结果的影响。方法：600名即将接受ICSI卵巢刺激的女性（300名使用长GnRH激动剂方案，300名使用GnRH拮抗剂方案）参加了这项研究。接受这两种方案治疗的患者在ICSI后6天随机分配接受单次GnRH激动剂或安慰剂注射。着床率和活产率是主要结局。结果：与安慰剂相比，ICSI后第6天给予0.1 mg GnRH激动剂triptorelin可显著改善ICSI后的着床率和活产率。在GnRH拮抗剂治疗的卵巢刺激周期中，黄体期GnRH激动剂也增加了持续妊娠率。此外，在两种卵巢刺激方案中，黄体期GnRH激动剂的使用增加了黄体期血清HCG、雌二醇和黄体酮的浓度。结论：在GnRH激动剂和GnRH拮抗剂治疗卵巢刺激周期后，黄体期给予GnRH激动剂可以提高ICSI的临床结果，可能是通过对胚胎和黄体的综合影响。
BACKGROUND: GnRH agonist was recently suggested as a novel luteal-phase support that may act at different levels, including the pituitary gonadotrophs, the endometrium and the embryo itself. This prospective randomized study evaluates the effect of GnRH agonist administered in the luteal phase on ICSI outcomes in both GnRH agonist- and GnRH antagonist-treated ovarian stimulation protocols. METHODS: Six hundred women about to undergo ovarian stimulation for ICSI (300 using a long GnRH agonist protocol and 300 using a GnRH antagonist protocol) were enrolled in this study. Patients treated with each of these two protocols were randomly assigned to receive a single injection of GnRH agonist or placebo 6 days after ICSI. Implantation and live birth rates were the primary outcomes. RESULTS: Administration of 0.1 mg of GnRH agonist triptorelin on day 6 after ICSI led to a significant improvement of implantation and live birth rates after ICSI as compared with placebo. In GnRH antagonist-treated ovarian stimulation cycles, luteal-phase GnRH agonist also increased ongoing pregnancy rate. Moreover, luteal-phase GnRH agonist administration increased luteal-phase serum HCG, estradiol and progesterone concentrations in both ovarian stimulation regimens. CONCLUSIONS: Luteal-phase GnRH agonist administration enhances ICSI clinical outcomes after GnRH agonist- and GnRH antagonist-treated ovarian stimulation cycles, possibly by a combination of effects on the embryo and the corpus luteum.