Huirne J A, Hugues J N, Pirard C, Fischl F, Sage J C, Pouly J L, Obruca A, Braat D M, van Loenen A C D, Lambalk C B
Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands.
Hum Reprod. 2006 Jun;21(6):1408-15. doi: 10.1093/humrep/del030. Epub 2006 Mar 14.
The aim of this study was to assess the non-inferiority of an oral contraceptive (OC)-pretreated cetrorelix regimen and a buserelin regimen in IVF/ICSI patients treated with r-hFSH in terms of total number of oocytes retrieved.
Multicentre, randomized study. One hundred and eighty two patients were randomized to receive cetrorelix with OC pretreatment (n = 91) or to receive buserelin (n = 91). The cetrorelix group started with daily OCs on cycle day 5 and continued for 21-28 days. Cetrorelix (0.25 mg) was given daily from stimulation day 6 up to and including the day of r-hCG administration. The buserelin group started with buserelin (500 microg/day) for at least 10 days until down-regulation was achieved, after which the dose was reduced to daily 200 microg up to and including the day of r-hCG administration. r-hFSH was started in both groups on a Friday, in the cetrorelix group 5 days after the last OC pill intake. Both regimens were followed by a standard IVF or ICSI procedure. The primary efficacy endpoint was the number of oocytes retrieved per patient.
Number of oocytes, cancellation rates, r-hFSH requirements, number of oocyte retrievals during the weekend or public holiday and number of pregnancies were similar in both groups. Both treatment regimens were well tolerated.
Cetrorelix pretreated with OCs resulted in similar number of oocytes retrieved compared with a long buserelin protocol. Both regimens were well tolerated and allowed scheduling of the oocyte retrieval, with only small number of retrievals falling on a weekend or public holiday.
本研究旨在评估在接受重组人促卵泡激素(r-hFSH)治疗的体外受精/卵胞浆内单精子注射(IVF/ICSI)患者中,口服避孕药(OC)预处理的西曲瑞克方案与布舍瑞林方案在获卵总数方面的非劣效性。
多中心随机研究。182例患者被随机分为接受OC预处理的西曲瑞克组(n = 91)或接受布舍瑞林组(n = 91)。西曲瑞克组在周期第5天开始每日服用OC,持续21 - 28天。从刺激第6天直至包括注射r-hCG当天,每日给予西曲瑞克(0.25 mg)。布舍瑞林组开始时给予布舍瑞林(500μg/天)至少10天,直至达到降调节,之后剂量减至每日200μg,直至包括注射r-hCG当天。两组均在周五开始使用r-hFSH,西曲瑞克组在最后一片OC药片服用5天后开始。两种方案之后均采用标准的IVF或ICSI程序。主要疗效终点是每位患者的获卵数。
两组的获卵数、取消率、r-hFSH需求量、周末或公共假日的取卵次数以及妊娠数均相似。两种治疗方案耐受性均良好。
与长方案布舍瑞林相比,OC预处理的西曲瑞克获卵数相似。两种方案耐受性均良好,且允许安排取卵时间,只有少数取卵发生在周末或公共假日。