Impact of Mid-Luteal Phase GnRH Agonist Administration on Reproductive Outcomes in GnRH Agonist-Triggered Cycles: A Randomized Controlled Trial
Impact of Mid-Luteal Phase GnRH Agonist Administration on Reproductive Outcomes in GnRH Agonist-Triggered Cycles: A Randomized Controlled Trial
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DOI：
10.3389/fendo.2017.00124
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发表时间：
2017-06-15
影响因子：
5.2
通讯作者：
Humaidan, Peter
中科院分区：
文献类型：
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作者：
Benmachiche, Abdelhamid;Benbouhedja, Sebti;Humaidan, Peter
目的：探讨在体外受精（IVF）周期中加入黄体中期促性腺激素释放激素激动剂（GnRHa）是否能提高着床率（IR）。设计：一项随机对照试验。设置：私人IVF中心。患者：328例IVF/卵胞浆内单精子注射患者接受GnRHa触发，500 IU HCG在取卵当天（OPU）除了标准的黄体期支持（LPS）。干预措施：此外，研究组在OPU后6天接受了GnRHa推注，而对照组没有。主要结果测量：着床率。次要结局指标：持续妊娠率（OP）和活产率（LB）。尽管研究组在OPU + 7天的FSH、LH、E2和P血清浓度显着高于对照组，治疗组和对照组的IR发生率分别为27%和23%，差异无统计学意义[比值比（OR）1.2（95% CI 0.9-1.7），P < 0.27]。同样，治疗组OP发生率为37%，对照组为31%[OR 1.3（95% CI 0.8-2.0），P < 0.23]。治疗组妊娠率为36%，对照组为31%[OR：1.3（95% CI 0.8-2.0），P < 0.27]。结论：治疗组妊娠率和胰岛素抵抗有升高趋势，但无统计学意义。然而，LB的绝对风险差异为5%，具有临床相关性，需要进一步研究。
Objective: To explore whether the addition of a mid-luteal bolus of GnRH agonist (GnRHa) improves the implantation rate (IR) in in vitro fertilization (IVF) cycles.Design: A randomized controlled trial.Setting: Private IVF center.Patients: 328 IVF/intracytoplasmic sperm injection patients were triggered with GnRHa and received 1,500 IU HCG on the day of oocyte pick-up (OPU) in addition to a standard luteal phase support (LPS).Intervention(s): In addition, the study group received a bolus of GnRHa 6 days after OPU, whereas the control group did not.Main outcome measure: Implantation rate.Secondary outcome measure(s): Ongoing pregnancy (OP) and live birth (LB) rates.Results: Although serum concentrations of FSH, LH, E2, and P on day OPU + 7 were significantly higher in the study group compared to the control group, the IR was not statistically different between the treatment group (27%) and the control group (23%) [odds ratio (OR) 1.2 (95% CI 0.9-1.7), P < 0.27]. Similarly, the OP rate was 37% in the treatment group and 31% in the control group [OR 1.3 (95% Cl 0.8-2.0), P < 0.23]. The LB rate was 36% in the treatment group and 31% in the control group [OR: 1.3 (95% Cl 0.8-2.0), P < 0.27].Conclusion: Although a trend toward a higher IR and pregnancy rate was observed in the treatment group, this difference was not statistically significant. However, the absolute risk difference of 5% found for LB is clinically relevant, warranting further investigation.