Itskovitz J, Boldes R, Levron J, Erlik Y, Kahana L, Brandes J M
Rambam Medical Center, Technion Israel Institute of Technology, Faculty of Medicine, Haifa.
Fertil Steril. 1991 Aug;56(2):213-20.
To use gonadotropin-releasing hormone agonist (GnRH-a) instead of human chorionic gonadotropin (hCG) to induce oocyte maturation for in vitro fertilization (IVF).
Pituitary and ovarian responses to GnRH-a and the outcome of IVF were studied prospectively. Data from patients injected with hCG were analyzed retrospectively.
Program of IVF at the Rambam (Governmental) Hospital, Haifa, Israel.
One or two doses of buserelin acetate 250 to 500 micrograms were administered to six patients with moderate response (Estradiol [E2], 1,494 +/- 422 [+/- SD] pg/mL) and 8 patients with exaggerated response (E2, 7,673 +/- 3,028 pg/mL) to gonadotropin stimulation. Progesterone (P) and E2 were administered for luteal support.
Gonadotropin-releasing hormone agonist effectively triggered luteinizing hormone (LH)/follicle-stimulating hormone (FSH) surge. Mature oocytes were recovered in all patients. Luteal E2 and P were lower than in patients injected with hCG. No signs of ovarian hyperstimulation syndrome were observed.
Serum LH and FSH rose over 4 and 12 hours, respectively, and were significantly (P less than 0.05) elevated for 24 hours. Of all mature oocytes, 67% fertilized and 82% cleaved. Four pregnancies were obtained.
A bolus of GnRH-a is able to trigger an adequate midcycle LH/FSH surge, resulting in oocyte maturation and pregnancy. Our preliminary results also suggest that it allows a more accurate control of ovarian steroid levels during the luteal phase and may prevent the clinical manifestation of ovarian hyperstimulation syndrome.
使用促性腺激素释放激素激动剂（GnRH-a）替代人绒毛膜促性腺激素（hCG）来诱导卵母细胞成熟以用于体外受精（IVF）。
前瞻性研究垂体和卵巢对GnRH-a的反应以及IVF的结果。回顾性分析注射hCG患者的数据。
以色列海法兰巴姆（政府）医院的IVF项目。
对6例促性腺激素刺激反应中等（雌二醇[E2]，1494±422[±标准差]pg/mL）的患者和8例反应过度（E2，7673±3028 pg/mL）的患者给予1或2剂250至500微克的醋酸布舍瑞林。给予黄体酮（P）和E2进行黄体支持。
促性腺激素释放激素激动剂有效触发促黄体生成素（LH）/促卵泡生成素（FSH）峰。所有患者均回收了成熟卵母细胞。黄体期的E2和P低于注射hCG的患者。未观察到卵巢过度刺激综合征的迹象。
血清LH和FSH分别在4小时和12小时内升高，并在24小时内显著（P<0.05）升高。在所有成熟卵母细胞中，67%受精，82%分裂。获得了4次妊娠。
一剂GnRH-a能够触发足够的周期中期LH/FSH峰，从而导致卵母细胞成熟和妊娠。我们的初步结果还表明，它可以在黄体期更精确地控制卵巢类固醇水平，并可能预防卵巢过度刺激综合征的临床表现。
