Cessation of gonadotropin-releasing hormone antagonist on triggering day: an alternative method for flexible multiple-dose protocol.
Cessation of gonadotropin-releasing hormone antagonist on triggering day: an alternative method for flexible multiple-dose protocol.
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DOI：
10.3346/jkms.2009.24.2.262
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发表时间：
2009-04
影响因子：
4.5
通讯作者：
Kim SH
中科院分区：
文献类型：
--
作者：
Chang HJ;Lee JR;Jee BC;Suh CS;Kim SH
本研究回顾性分析了促性腺激素释放激素（GnRH）拮抗剂在排卵触发日省略的体外受精（IVF）周期的结局。共有92个连续的IVF周期被纳入65名接受重组FSH卵巢刺激的妇女。当主导卵泡直径达到14 mm时，开始使用GnRH拮抗剂西曲瑞克0.25 mg/天，直至hCG给药日（A组，66个周期）或直至hCG给药前一天（B组，26个周期）。两组间促排卵持续时间、促性腺激素总剂量、hCG给药日血清雌二醇水平和获卵数无显著差异。与A组相比，B组的GnRH拮抗剂总剂量显著较低（2.7±0.8 vs. 3.2±0.9安瓿）。受试者未出现过早黄体化。B组的成熟卵比例（71.4%）和成熟受精率（86.3±19.7%）显著高于对照组（61.7%）和对照组（71.8±31.7%）。胚胎质量和临床妊娠率无明显差异。我们的研究结果表明，在灵活的多次给药方案中，在hCG给药当天停止GnRH拮抗剂可以减少GnRH拮抗剂的总剂量，而不会影响IVF结果。
This study was performed to analyze retrospectively outcomes of stimulated in vitro fertilization (IVF) cycles where the gonadotropin-releasing hormone (GnRH) antagonist was omitted on ovulation triggering day. A total of 92 consecutive IVF cycles were included in 65 women who are undergoing ovarian stimulation with recombinant FSH. A GnRH antagonist, cetrorelix 0.25 mg/day, was started when leading follicle reached 14 mm in diameter until the day of hCG administration (Group A, 66 cycles) or until the day before hCG administration (Group B, 26 cycles). The duration of ovarian stimulation, total dose of gonadotropins, serum estradiol levels on hCG administration day, and the number of oocytes retrieved were not significantly different between the two groups. The total dose of GnRH antagonist was significantly lower in Group B compared to Group A (2.7±0.8 vs. 3.2±0.9 ampoules). There was no premature luteinization in the subjects. The proportion of mature oocytes (71.4% vs. 61.7%) and fertilization rate of mature (86.3±19.7% vs. 71.8±31.7%) was significantly higher in Group B. There were no significant differences in embryo quality and clinical pregnancy rates. Our results suggest that cessation of the GnRH antagonist on the day of hCG administration during a flexible multiple-dose protocol could reduce the total dose of GnRH antagonist without compromising IVF results.
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