Nikolettos N, Al-Hasani S, Felberbaum R, Demirel L C, Riethmüller-Winzen H, Reissmann T, Schöpper B, Sturm R, Diedrich K
Democritus University of Thrace, Faculty of Medicine, Alexandroupolis, Greece.
Eur J Obstet Gynecol Reprod Biol. 2000 Nov;93(1):91-5. doi: 10.1016/s0301-2115(99)00294-8.
This retrospective study was performed to examine the implantation and pregnancy rates of frozen-thawed pronuclear stage oocytes obtained with the use of a GnRH antagonist, Cetrorelix (Cetrotide((R)) ASTA-Medica, Frankfurt/M, Germany) used in a multidose protocol with hMG, and to compare these results with those obtained after a conventional long GnRH analogue protocol (Decapeptyl-Depot, Ferring, Kiel, Germany). The study population consisted of 31 infertile couples with frozen-thawed pronuclear stage oocytes after ICSI treatment using the GnRH antagonist Cetrorelix (Cetrorelix((R))) and 31 infertile couples with frozen-thawed pronuclear stage oocytes after ICSI treatment using the long GnRH analogue protocol. Patients underwent ICSI after down regulation with a GnRH agonist (Decapeptyl) and stimulation with hMG, or a GnRH antagonist (Cetrorelix) and hMG. The supernumerary pronuclear stage oocytes were cryopreserved and transferred in a later mildly stimulated cycle. The implantation and pregnancy rates for frozen-thawed pronuclear stage oocytes derived from the GnRH antagonist compared with the GnRH agonist were 3.26% versus 3.73% (P=1.0000) and 8.33% versus 10.25% (P=1.0000), respectively. To our knowledge we report here the first pregnancies obtained by the transfer of cryopreserved pronuclear stage embryos generated from ICSI using a GnRH antagonist in the collecting cycle. The use of Cetrorelix in a multiple dose protocol in combination with hMG does not demonstrate a negative effect on viability, implantation potential or pregnancy outcome as compared to 2PN conceptuses obtained from a long GnRH agonist-hMG protocol.
本回顾性研究旨在检测使用促性腺激素释放激素（GnRH）拮抗剂西曲瑞克（Cetrotide((R))，ASTA - Medica，德国法兰克福）并采用多剂量方案联合人绝经期促性腺激素（hMG）获取的冻融原核期卵母细胞的着床率和妊娠率，并将这些结果与采用传统长效GnRH类似物方案（曲普瑞林长效注射剂，Ferring，德国基尔）后获得的结果进行比较。研究人群包括31对不育夫妇，他们在使用GnRH拮抗剂西曲瑞克（Cetrorelix((R))）进行卵胞浆内单精子注射（ICSI）治疗后有冻融原核期卵母细胞；以及31对不育夫妇，他们在使用长效GnRH类似物方案进行ICSI治疗后有冻融原核期卵母细胞。患者在使用GnRH激动剂（曲普瑞林）进行降调节并使用hMG刺激后，或使用GnRH拮抗剂（西曲瑞克）和hMG后接受ICSI。多余的原核期卵母细胞被冷冻保存，并在随后的轻度刺激周期中进行移植。与GnRH激动剂相比，GnRH拮抗剂来源的冻融原核期卵母细胞的着床率分别为3.26%和3.73%（P = 1.0000），妊娠率分别为8.33%和10.25%（P = 1.0000）。据我们所知，我们在此报告了首次通过移植在采集周期中使用GnRH拮抗剂经ICSI产生的冻融原核期胚胎而获得的妊娠情况。与从长效GnRH激动剂 - hMG方案获得的双原核胚胎相比，在多剂量方案中使用西曲瑞克联合hMG对活力、着床潜力或妊娠结局未显示出负面影响。
