Ovarian stimulation in women with high and normal body mass index: GnRH agonist versus GnRH antagonist
Ovarian stimulation in women with high and normal body mass index: GnRH agonist versus GnRH antagonist
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DOI：
10.3109/09513590.2012.664192
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发表时间：
2012-10-01
影响因子：
2
通讯作者：
Moscarini, Massimo
中科院分区：
文献类型：
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作者：
Marci, Roberto;Lisi, Franco;Moscarini, Massimo
在现代社会，肥胖已成为一个主要的健康问题，并与生育能力受损有关。本研究的目的是评估肥胖对接受 GnRH 激动剂或 GnRH 拮抗剂刺激的受控卵巢过度刺激 (COH) 的女性的影响。审查了 463 名接受体外受精 (IVF) 治疗的女性的记录。在考虑刺激方案的差异后，检查了体重指数（BMI）对治疗结果的影响。在激动剂组（286 名患者）中，与 BMI 正常的患者相比，BMI >= 25 kg/m(2) 的患者使用的促性腺激素总量显着更高。在拮抗剂组（177 名患者）中也发现了相同的结果。在刺激时间、取出的卵母细胞数量或移植胚胎数量方面没有发现显着差异。在拮抗剂组和激动剂组中，体重指数正常的患者的临床妊娠次数较高，这表明肥胖可能会损害卵巢对外源性促性腺激素的反应。考虑到所获得的结果以及 GnRH 拮抗剂的许多理论优势，使用 GnRH 拮抗剂进行卵巢刺激对于 BMI 正常和高的女性来说都是一种有效的治疗方法。
In modern society, obesity has become a major health problem and has been associated with impaired fertility. The aim of this study is to assess the role of obesity in women undergoing controlled ovarian hyperstimulation (COH) stimulated either with GnRH agonists or with GnRH antagonists. Records of 463 women undergoing in vitro fertilization (IVF) treatment were reviewed. The influence of body mass index (BMI) on treatment outcome was examined, after accounting for differences in stimulation protocols. In the agonist group (286 patients), the total amount of gonadotropins used was significantly higher in patients with a BMI >= 25 kg/m(2), when compared to those with a normal BMI. The same result was found in the antagonist group (177 patients). No significant differences were found in length of stimulation, number of oocytes retrieved or number of embryos transferred. In both the antagonist and the agonist group, the number of clinical pregnancies was found to be higher in patients with normal BMI, suggesting that obesity could impair the ovarian response to exogenous gonadotropins. Considering the results obtained and the many theoretical advantages of GnRH antagonists, ovarian stimulation with GnRH antagonists is an efficient treatment for both women with normal and high BMI.