Filicori Marco, Cognigni Graciela E, Pocognoli Patrizia, Tabarelli Cristina, Ferlini Federica, Perri Tiziana, Parmegiani Lodovico
Reproductive Endocrinology Center, University of Bologna, Bologna, Italy.
Fertil Steril. 2003 Aug;80(2):390-7. doi: 10.1016/s0015-0282(03)00594-6.
To carefully examine the features of controlled ovarian stimulation performed with recombinant FSH-alpha or hMG.
Controlled, prospective, randomized comparison of fixed gonadotropin regimens.
Academic research institution.
PATIENT(S): Fifty infertile patients who were candidates for IUI.
INTERVENTION(S): Patients were randomized to receive a fixed regimen of recombinant FSH-alpha (150 IU/day, 25 patients) or hMG (150 IU/day, 25 patients), after GnRH-agonist suppression (long regimen).
Daily measurements of serum LH, immunoreactive FSH, hCG, E(2), P, and T. Transvaginal pelvic ultrasound every 2 days. Pregnancy and abortion rates. Cost of medications. Two recombinant FSH-alpha-treated patients did not respond. Despite matched daily FSH dose, duration of treatment (hMG 10.8 +/- 0.4 vs. recombinant FSH-alpha 12.4 +/- 0.5 days), gonadotropin dose (21.7 +/- 0.8 vs. 25.3 +/- 1.3 ampoules), gonadotropin cost (288 +/- 10 vs. 1,299 +/- 66 /cycle), serum P levels, and small preovulatory follicle number were significantly lower, and LH, hCG, immunoreactive FSH levels, and larger follicles on day 8 were significantly higher in hMG-treated patients. The pregnancy, abortion, and twin pregnancy rates did not differ.
The hMG administration was associated with: [1]. increased serum LH activity and immunoreactive FSH levels during treatment; [2]. reduced signs of premature luteinization; [3]. differential modulation of folliculogenesis; [4]. lower treatment duration, gonadotropin dose, and cost; and [5]. clinical outcome comparable to recombinant FSH-alpha.
仔细研究使用重组促卵泡素α或人绝经期促性腺激素进行控制性卵巢刺激的特征。
固定促性腺激素方案的对照、前瞻性、随机比较。
学术研究机构。
50例符合宫腔内人工授精条件的不育患者。
在促性腺激素释放激素激动剂抑制（长方案）后，患者被随机分配接受固定方案的重组促卵泡素α（150IU/天，25例患者）或人绝经期促性腺激素（150IU/天，25例患者）。
每日测定血清促黄体生成素、免疫反应性促卵泡素、人绒毛膜促性腺激素、雌二醇、孕酮和睾酮。每2天经阴道盆腔超声检查。妊娠率和流产率。药物费用。两名接受重组促卵泡素α治疗的患者无反应。尽管每日促卵泡素剂量匹配，但人绝经期促性腺激素治疗组患者的治疗持续时间（10.8±0.4天对重组促卵泡素α组12.4±0.5天）、促性腺激素剂量（21.7±0.8安瓿对25.3±1.3安瓿）、促性腺激素费用（288±10对1299±66/周期）、血清孕酮水平和排卵前小卵泡数量显著较低，而促黄体生成素、人绒毛膜促性腺激素、免疫反应性促卵泡素水平以及第8天较大卵泡数量在人绝经期促性腺激素治疗组显著较高。妊娠率、流产率和双胎妊娠率无差异。
人绝经期促性腺激素给药与以下情况相关：[1]治疗期间血清促黄体生成素活性和免疫反应性促卵泡素水平升高；[2]过早黄素化迹象减少；[3]卵泡生成的差异调节；[4]治疗持续时间、促性腺激素剂量和费用较低；[5]临床结局与重组促卵泡素α相当。
