GnRH拮抗剂联合枸橼酸氯米芬和人绝经期促性腺激素在既往IVF/ICSI周期中卵巢反应过度患者中的应用。
Application of GnRH antagonist in combination with clomiphene citrate and hMG for patients with exaggerated ovarian response in previous IVF/ICSI cycles.
作者信息
Lin Yu-Hung, Seow Kok-Min, Hsieh Bih-Chwen, Huang Lee-Wen, Chen Heng-Ju, Huang Shih-Chia, Chen Chih-Yu, Chen Pei-Hsin, Hwang Jiann-Loung, Tzeng Chi-Ruey
机构信息
Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wen Chang Road, Shih Lin District, Taipei, 111, Taiwan.
出版信息
J Assist Reprod Genet. 2007 Aug;24(8):331-6. doi: 10.1007/s10815-007-9127-8. Epub 2007 Jul 17.
PURPOSE
To investigate if the combination of clomiphene citrate, hMG, and cetrorelix (CC/hMG/cetrorelix protocol) can be applied to patients who had excessive response to GnRHa long protocol.
METHODS
Fifty patients who coasted and failed to conceive in their first cycles stimulated with GnRHa long protocol were stimulated with CC/hMG/cetrorelix protocol. The peak serum estradiol levels, the need of coasting and prolonged coasting (>/=4 days), and the incidences of OHSS were compared.
RESULTS
The peak estradiol level was significantly lower with CC/hMG/cetrorelix protocol compared to GnRHa long protocol. With CC/hMG/cetrorelix protocol, only four patients (8%) needed coasting and no one coasted >/=4 days. In contrast, in the first cycles, 11 patients (22%) needed coasting >/=4 days. The incidence of moderate OHSS was significantly lower with CC/hMG/cetrorelix protocol.
CONCLUSIONS
The CC/hMG/cetrorelix protocol is an acceptable alternative protocol for patients who had excessive response to GnRHa long protocol.
目的
探讨枸橼酸氯米芬、人绝经期促性腺激素（hMG）和西曲瑞克联合方案（CC/hMG/西曲瑞克方案）是否可应用于对促性腺激素释放激素激动剂（GnRHa）长方案反应过度的患者。
方法
50例在GnRHa长方案刺激的首个周期中出现卵泡发育停滞且未受孕的患者，采用CC/hMG/西曲瑞克方案进行刺激。比较血清雌二醇峰值水平、卵泡发育停滞及延长卵泡发育停滞（≥4天）的需求以及卵巢过度刺激综合征（OHSS）的发生率。
结果
与GnRHa长方案相比，CC/hMG/西曲瑞克方案的雌二醇峰值水平显著降低。采用CC/hMG/西曲瑞克方案时，仅4例患者（8%）需要卵泡发育停滞，且无人卵泡发育停滞≥4天。相比之下，在首个周期中，11例患者（22%）需要卵泡发育停滞≥4天。CC/hMG/西曲瑞克方案中重度OHSS的发生率显著降低。
结论
CC/hMG/西曲瑞克方案是对GnRHa长方案反应过度患者可接受的替代方案。
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