DiLuigi Andrea J, Nulsen John C
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Connecticut Health Center, Farmington, Connecticut 06030-6224, USA.
Curr Opin Obstet Gynecol. 2007 Jun;19(3):258-65. doi: 10.1097/GCO.0b013e3281338874.
This review addresses the effects of gonadotropin-releasing hormone agonists and antagonists on various aspects of the luteal phase.
Recent studies have shown that use of both gonadotropin-releasing hormone agonists and antagonists during in-vitro fertilization cycles leads to alterations in the hormonal profiles of the luteal phase as well as changes in endometrial histology. Gonadotropin-releasing hormone agonists are effective in triggering final oocyte maturation and reducing the incidence of ovarian hyperstimulation syndrome. Ongoing pregnancy rates are excellent after gonadotropin-releasing hormone agonist trigger when luteal phase and early pregnancy supplementation with estradiol and progesterone is provided. Gonadotropin-releasing hormone agonists have recently been used for luteal phase support in in-vitro fertilization cycles.
Although gonadotropin-releasing hormone agonists and antagonists are clinically useful, they may have adverse effects on luteal function. Luteal phase supplementation significantly improves clinical outcomes in in-vitro fertilization cycles because it may correct some of these detrimental effects. Use of gonadotropin-releasing hormone agonist to induce oocyte maturation is beneficial to patients who are at increased risk for ovarian hyperstimulation syndrome. The key factor in achieving favorable ongoing pregnancy rates with use of gonadotropin-releasing hormone agonist to induce oocyte maturation appears to be adequate luteal phase support.
本综述探讨促性腺激素释放激素激动剂和拮抗剂对黄体期各个方面的影响。
近期研究表明，在体外受精周期中使用促性腺激素释放激素激动剂和拮抗剂均会导致黄体期激素水平改变以及子宫内膜组织学变化。促性腺激素释放激素激动剂在触发最终卵母细胞成熟和降低卵巢过度刺激综合征发生率方面有效。当在黄体期和妊娠早期补充雌二醇和孕酮时，使用促性腺激素释放激素激动剂触发后的持续妊娠率良好。促性腺激素释放激素激动剂最近已用于体外受精周期的黄体期支持。
尽管促性腺激素释放激素激动剂和拮抗剂在临床上有用，但它们可能对黄体功能产生不利影响。黄体期补充剂可显著改善体外受精周期的临床结局，因为它可能纠正其中一些有害影响。使用促性腺激素释放激素激动剂诱导卵母细胞成熟对卵巢过度刺激综合征风险增加的患者有益。使用促性腺激素释放激素激动剂诱导卵母细胞成熟以实现良好持续妊娠率的关键因素似乎是充分的黄体期支持。
