Checa Miguel A, Prat María, Robles Ana, Carreras Ramón
Service of Obstetrics and Gynecology, Hospital Universitari del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain.
Fertil Steril. 2006 Mar;85(3):573-7. doi: 10.1016/j.fertnstert.2005.08.040.
To assess the usefulness of the GnRH antagonist cetrorelix to prevent LH surge and to avoid intrauterine insemination at weekends when a gynecologist on duty is not available and the ultrasound scan on Friday showed > 1 and < 3 follicles > or = 17 mm in diameter.
Open-label, randomized, prospective study.
Reproductive medicine unit in an acute care teaching hospital in Barcelona, Spain.
PATIENT(S): Infertile patients undergoing controlled ovarian hyperstimulation (COH) and IUI.
INTERVENTION(S): Treatment with recombinant FSH was started on day 3. In women assigned to the control group (n = 32), recombinant FSH was continued up to the day of hCG administration. In patients assigned to the GnRH antagonist group (n = 35), half of the dose of recombinant FSH was given for 2 more days in addition to cetrorelix (0.25 mg SC) until the day of hCG administration.
MAIN OUTCOME MEASURE(S): Recombinant FSH doses, E(2) level on the day of hCG administration, number and diameter of follicles, endometrial thickness, and number of pregnancies.
RESULT(S): Only a case of premature ovulation occurred in the cetrorelix group. There were no significant differences between the study groups in the total mean number of follicles, follicles > 10 mm and < 17 mm, and follicles > or = 17 mm. The mean concentration of E2 on the day of hCG administration and the endometrial thickness were significantly higher in the cetrorelix group. Eleven pregnancies were achieved, 7 (20%) in the cetrorelix group (4 singleton, 3 twins) and 4 (12.5%) in controls (4 singleton). No case of ovarian hyperstimulation syndrome (OHSS) occurred.
CONCLUSION(S): The use of cetrorelix to avoid IUI at weekends when the ultrasound scan on Friday shows > 1 and < 3 follicles > or = 17 mm is a useful alternative for medical centers in which a gynecologist on call is not available.
评估促性腺激素释放激素（GnRH）拮抗剂西曲瑞克在防止促黄体生成素（LH）峰出现以及避免在周末进行宫腔内人工授精（IUI）方面的有效性。当周末无妇科值班医生且周五超声检查显示有1个以上且小于3个直径≥17mm的卵泡时，可使用该药物。
开放标签、随机、前瞻性研究。
西班牙巴塞罗那一家急症护理教学医院的生殖医学科。
接受控制性卵巢过度刺激（COH）和IUI的不孕患者。
第3天开始使用重组促卵泡激素（FSH）治疗。分配至对照组（n = 32）的女性，重组FSH持续使用至注射人绒毛膜促性腺激素（hCG）当天。分配至GnRH拮抗剂组（n = 35）的患者，除西曲瑞克（0.25mg皮下注射）外，重组FSH剂量减半再使用2天，直至注射hCG当天。
重组FSH剂量、注射hCG当天的雌二醇（E₂）水平、卵泡数量和直径、子宫内膜厚度以及妊娠数。
西曲瑞克组仅发生1例过早排卵。研究组之间在卵泡总数、直径＞10mm且＜17mm的卵泡以及直径≥17mm的卵泡方面无显著差异。注射hCG当天E₂的平均浓度和子宫内膜厚度在西曲瑞克组显著更高。共实现11例妊娠，西曲瑞克组7例（20%）（4例单胎、3例双胎），对照组4例（12.5%）（4例单胎）。未发生卵巢过度刺激综合征（OHSS）病例。
对于没有随叫随到妇科医生的医疗中心，当周五超声检查显示有1个以上且小于3个直径≥17mm的卵泡时，使用西曲瑞克避免在周末进行IUI是一种有用的替代方法。
