低剂量人绒毛膜促性腺激素（hCG）在促性腺激素释放激素（GnRH）拮抗剂方案中的疗效。
Efficacy of low-dose human chorionic gonadotropin (hCG) in a GnRH antagonist protocol.
作者信息
Koichi Kyono, Yukiko Nakajo, Shima Kumagai, Sachiko Sasaki
机构信息
Kyono Ladies Clinic, Furukawa, Miyagi, Japan.
出版信息
J Assist Reprod Genet. 2006 May;23(5):223-8. doi: 10.1007/s10815-006-9036-2. Epub 2006 Jun 20.
PURPOSE
To examine the efficacy of low-dose hCG using a GnRH antagonist protocol.
METHODS
Prospective randomized study was performed at the Kyono Ladies Clinic. One hundred ninety-two women (<40 -years old, <3 previous cycles) were randomly assigned to GnRH agonist (buserelin) long protocol (LP, n = 66), GnRH antagonist (cetrorelix) with no low-dose hCG protocol (NhCGP, n = 63), or GnRH antagonist with low-dose hCG protocol (hCGP, n = 63).
RESULTS
The hCGP was associated with reduced total amounts of FSH, increased oocyte maturation rate, high-quality day 3 embryos rate, and number of frozen embryos. Ovarian hyperstimulation syndrome (OHSS) tended to be lower in the GnRH antagonist protocol. Pregnancy and implantation rates did not differ significantly between study groups.
CONCLUSIONS
Daily low-dose hCG supplementation in the late follicular phase could improve the outcome in FSH based-GnRH antagonist protocol. This protocol, however, does require further modifications, including determination of the optimal doses for hCG and gonadotropin pretreatment.
目的
使用促性腺激素释放激素（GnRH）拮抗剂方案研究低剂量人绒毛膜促性腺激素（hCG）的疗效。
方法
在京野女子诊所进行前瞻性随机研究。192名女性（年龄<40岁，既往周期<3个）被随机分配至GnRH激动剂（布舍瑞林）长方案组（LP，n = 66）、无低剂量hCG方案的GnRH拮抗剂（西曲瑞克）组（NhCGP，n = 63）或低剂量hCG方案的GnRH拮抗剂组（hCGP，n = 63）。
结果
hCGP组促卵泡生成素（FSH）总量减少、卵母细胞成熟率提高、优质第3天胚胎率及冷冻胚胎数量增加。GnRH拮抗剂方案中卵巢过度刺激综合征（OHSS）倾向于较低。各研究组之间的妊娠率和着床率无显著差异。
结论
在卵泡晚期每日补充低剂量hCG可改善基于FSH的GnRH拮抗剂方案的结局。然而，该方案确实需要进一步改进，包括确定hCG和促性腺激素预处理的最佳剂量。
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