Aboulghar Mohamed A, Mansour Ragaa T, Amin Yahia M, Al-Inany Hesham G, Aboulghar Mona M, Serour Gamal I
The Egyptian IVF-ET Centre, 3 St 161, Hadaek El Maadi, Maadi, Cairo 1143, Egypt.
Reprod Biomed Online. 2007 Sep;15(3):271-9. doi: 10.1016/s1472-6483(10)60339-2.
This work evaluated possible advantages of gonadotrophin-releasing hormone (GnRH) antagonist administration as an alternative to coasting in prevention of severe ovarian hyperstimulation syndrome (OHSS) in women undergoing IVF/ intracytoplasmic sperm injection. A prospective randomized study comparing coasting (group A) (n = 96) and GnRH antagonist administration (group B) (n = 94) in patients at risk of OHSS was performed. The primary outcome measure was high quality embryos. The secondary outcome measures were days of intervention, number of oocytes, pregnancy rate, number of cryopreserved embryos and incidence of severe OHSS. There were significantly more high quality embryos (2.87 +/- 1.2 versus 2.21 +/- 1.1; P < 0.0001), and more oocytes (16.5 +/- 7.6 versus 14.06 +/- 5.2; P = 0.02), in group B as compared with group A. There were more days of coasting as compared with days of antagonist administration (2.82 +/- 0.97 versus 1.74 +/- 0.91; P < 0.0001). In conclusion, GnRH antagonist was superior to coasting in producing significantly more high quality embryos and more oocytes as well as reducing the time until HCG administration. There was no significant difference in pregnancy rate between the two groups. No OHSS developed in either group.
本研究评估了给予促性腺激素释放激素（GnRH）拮抗剂作为一种替代方案，以取代在接受体外受精/卵胞浆内单精子注射的女性中预防严重卵巢过度刺激综合征（OHSS）时采用的“周期取消”策略的潜在优势。进行了一项前瞻性随机研究，比较有OHSS风险的患者中采用“周期取消”（A组）（n = 96）和给予GnRH拮抗剂（B组）（n = 94）的情况。主要结局指标为高质量胚胎。次要结局指标为干预天数、卵母细胞数量、妊娠率、冷冻保存胚胎数量及严重OHSS的发生率。与A组相比，B组有显著更多的高质量胚胎（2.87±1.2对2.21±1.1；P<0.0001）和更多的卵母细胞（16.5±7.6对14.06±5.2；P = 0.02）。与给予拮抗剂的天数相比，“周期取消”的天数更多（2.82±0.97对1.74±0.91；P<0.0001）。总之，GnRH拮抗剂在产生显著更多的高质量胚胎和更多的卵母细胞以及减少至注射人绒毛膜促性腺激素（HCG）的时间方面优于“周期取消”策略。两组间妊娠率无显著差异。两组均未发生OHSS。
