Del Gadillo Juan C Barros, Siebzehnrübl Ernst, Dittrich Ralf, Wildt Ludwig, Lang Norbert
Universitäts Frauenklinik Erlangen, Universitäts str. 21-23, D-91054 Erlangen, Germany.
Eur J Obstet Gynecol Reprod Biol. 2002 May 10;102(2):179-83. doi: 10.1016/s0301-2115(01)00580-2.
To evaluate the results of the use of GnRH antagonist (GnRHant) and GnRH analog (GnRHa) in two matched groups of unselected IVF/ICSI patients in a retrospective matched pair analysis.
Patients (n=52) were stimulated with human menopausal gonadotropin (hMG) and/or recombinant FSH (rFSH). In Group I (n=26) a daily dose of 0.25mg of Cetrorelix (GnRHant) was administered when follicles reached a diameter of > or = 14 mm. Patients in Group II (n=26) were first desensitized with GnRHa triptorelin long protocol, which was continued during the gonadotropins treatment until the induction of ovulation.
In both groups, serum LH levels remained low during the stimulation. The mean length of stimulation, and the dose of FSH required per patient were similar in both groups. The mean E2 level on day of hCG administration was significantly higher in the patients of Group II (2076+/-1430 versus 1145+/-605 pg/ml), however, a progressive increase in serum E2 concentration during the cycle was noted in both groups. A median of 5.38 and 6.34 mature oocytes per patient was obtained, and the fertilization rate was 59.3% in Group I and 63.6% in Group II. Pregnancy rate (PR) were better in Group II (15 versus 5%), and no severe or moderate ovarian hyperstimulation syndrome (OHSS) occurred.
GnRHant and GnRHa provide comparable results in unselected patients, while GnRHant allows a higher flexibility in the treatment.
通过回顾性配对分析，评估在两组未经选择的体外受精/卵胞浆内单精子注射（IVF/ICSI）患者中使用促性腺激素释放激素拮抗剂（GnRHant）和促性腺激素释放激素类似物（GnRHa）的结果。
患者（n = 52）接受人绝经期促性腺激素（hMG）和/或重组促卵泡激素（rFSH）刺激。在第一组（n = 26）中，当卵泡直径≥14 mm时，每日给予0.25 mg西曲瑞克（GnRHant）。第二组（n = 26）的患者首先采用GnRHa曲普瑞林长方案进行降调节，在促性腺激素治疗期间持续使用直至诱导排卵。
两组在刺激过程中血清促黄体生成素（LH）水平均保持较低。两组的平均刺激时间和每位患者所需的FSH剂量相似。在注射人绒毛膜促性腺激素（hCG）当天，第二组患者的平均雌二醇（E2）水平显著更高（2076±1430 vs 1145±605 pg/ml），然而，两组在周期中血清E2浓度均呈现逐渐升高。每位患者分别获得中位数为5.38和6.34个成熟卵母细胞，第一组的受精率为59.3%，第二组为63.6%。第二组的妊娠率（PR）更高（15% vs 5%），且未发生严重或中度卵巢过度刺激综合征（OHSS）。
在未经选择的患者中，GnRHant和GnRHa的效果相当，而GnRHant在治疗中具有更高的灵活性。
