Loutradis D, Kallianidis K, Sakellaropoulos G, Dokos J, Siskos K, Creatsas G, Deligeoroglou E, Michalas S, Aravantinos D
First Department of Obstetrics, Gynecology, University of Athens, Medical School Alexandra Maternity Hospital, Greece.
Gynecol Obstet Invest. 1991;32(2):68-71. doi: 10.1159/000292997.
Gonadotropin-releasing hormone analogues (GnRH-a) are currently used in combination with gonadotropins in ovarian stimulation for in vitro fertilization programs (IVF). The present study aims at evaluating the treatment cycles for IVF for which human menopausal gonadotropin (HMG) was initiated only when pituitary desensitization was confirmed regardless of the time of GnRH-a administration. Two groups of patients were examined. Patients in group A (n = 46) were commenced with HMG treatment on day 15 when E2 level was less than 40 pg/ml. Group B patients (n = 27) comprised the cycle treatments in which E2 levels were greater than 40 pg/ml on day 15. In these cases HMG was first given when E2 levels declined to less than 40 pg/ml. The fertilization rate was similar in both A and B groups, 71.6 and 67.7% respectively. The pregnancy rate per transfer was 27.5 and 34.6% in group A and B respectively. Multiple pregnancies were found at 18.1% in group A versus 44.4% in group B. It is concluded that postponement of HMG administration in patients with high levels of E2 on day 15 after GnRH-a administration seems to offer an improvement in embryo cleavage speed, pregnancy rate and multiple pregnancies.
促性腺激素释放激素类似物（GnRH-a）目前在体外受精（IVF）的卵巢刺激中与促性腺激素联合使用。本研究旨在评估IVF治疗周期，即仅在确认垂体脱敏后才开始使用人绝经期促性腺激素（HMG），而不考虑GnRH-a的给药时间。研究检查了两组患者。A组（n = 46）患者在第15天当E2水平低于40 pg/ml时开始HMG治疗。B组患者（n = 27）包括第15天E2水平大于40 pg/ml的周期治疗。在这些情况下，当E2水平降至低于40 pg/ml时首次给予HMG。A组和B组的受精率相似，分别为71.6%和67.7%。A组和B组每次移植的妊娠率分别为27.5%和34.6%。A组的多胎妊娠率为18.1%，而B组为44.4%。得出的结论是，在GnRH-a给药后第15天E2水平高的患者中推迟HMG给药似乎能改善胚胎分裂速度、妊娠率和多胎妊娠情况。
