促性腺激素释放激素（GnRH）拮抗剂与GnRH激动剂在体外受精（IVF）中对卵巢反应不良者进行卵巢刺激时的比较。

Gonadotropin-releasing hormone (GnRH)-antagonist versus GnRH-agonist in ovarian stimulation of poor responders undergoing IVF.

作者信息

Fasouliotis Sozos J, Laufer Neri, Sabbagh-Ehrlich Shelley, Lewin Aby, Hurwitz Arye, Simon Alex

机构信息

IVF Unit, Department of Obstetrics and Gynecology, Hebrew University-Hadassah Medical Center, Ein Kerem, PO Box 12000, 91120 Jerusalem, Israel.

出版信息

J Assist Reprod Genet. 2003 Nov;20(11):455-60. doi: 10.1023/b:jarg.0000006707.88826.e7.

DOI:10.1023/b:jarg.0000006707.88826.e7

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3455641/

Abstract

PURPOSE

The objective of this study was to compare the efficacy of GnRH-antagonists to GnRH-agonists in ovarian stimulation of poor responders undergoing IVF.

METHODS

Retrospective analysis of our data revealed that 56 patients underwent treatment with a GnRH-agonist according to the flare-up protocol. Patients failing to achieve an ongoing pregnancy (n = 53) were subsequently treated in the next cycle with a GnRH-antagonist according to the multiple-dose protocol. Main outcome measures included the clinical pregnancy and implantation rates.

RESULTS

While ovulation induction characteristics and results did not differ between the two protocols, the number of embryos transferred was significantly higher (P = 0.046) in the GnRH-antagonist than in the GnRH-agonist stimulation protocol (2.5 +/- 1.6 vs. 2.0 +/- 1.4, respectively). The clinical pregnancy and implantation rates per transfer in the GnRH-antagonist group appeared higher than in the GnRH-agonist, but did not differ statistically (26.1 and 10.7 compared with 12.2 and 5.9%, respectively). However, the ongoing pregnancy rate per transfer was statistically significantly higher (P = 0.03) in the GnRH-antagonist than in the GnRH-agonist group (23.9 vs. 7.3%, respectively).

CONCLUSION

Applying GnRH-antagonists to ovarian stimulation protocols may offer new hope for IVF poor responder patients. However, further controlled randomized prospective studies with larger sample sizes are required to establish these results.

摘要

目的

本研究的目的是比较促性腺激素释放激素（GnRH）拮抗剂与GnRH激动剂在体外受精（IVF）中对卵巢反应不良者进行卵巢刺激的疗效。

方法

对我们的数据进行回顾性分析发现，56例患者根据激发方案接受了GnRH激动剂治疗。未实现持续妊娠的患者（n = 53）随后在下一周期根据多剂量方案接受GnRH拮抗剂治疗。主要结局指标包括临床妊娠率和着床率。

结果

虽然两种方案之间的排卵诱导特征和结果没有差异，但GnRH拮抗剂组移植的胚胎数量显著高于GnRH激动剂刺激方案组（分别为2.5±1.6和2.0±1.4，P = 0.046）。GnRH拮抗剂组每次移植的临床妊娠率和着床率似乎高于GnRH激动剂组，但差异无统计学意义（分别为26.1%和10.7%，而GnRH激动剂组分别为12.2%和5.9%）。然而，GnRH拮抗剂组每次移植的持续妊娠率在统计学上显著高于GnRH激动剂组（分别为23.9%和7.3%，P = 0.03）。

结论

将GnRH拮抗剂应用于卵巢刺激方案可能为IVF卵巢反应不良患者带来新的希望。然而，需要进一步进行更大样本量的对照随机前瞻性研究来证实这些结果。