The Fertility Clinic, Skive Regional Hospital, Resenvej 25, 7800 Skive, Denmark.
Fertil Steril. 2010 Feb;93(3):847-54. doi: 10.1016/j.fertnstert.2008.12.042. Epub 2009 Feb 6.
To prospectively assess the reproductive outcome with a small bolus of hCG administered on the day of oocyte retrieval after ovulation induction with a GnRH agonist (GnRHa).
Prospective, randomized trial.
Three hospital-based IVF clinics.
PATIENT(S): Three hundred five IVF/intracytoplasmic sperm injection patients after a GnRH antagonist protocol.
INTERVENTION(S): Ovulation induction was performed with either 10,000 IU hCG or 0.5 mg GnRHa (buserelin) supplemented with 1,500 IU hCG on the day of oocyte retrieval.
MAIN OUTCOME MEASURE(S): Reproductive outcome in the two groups.
RESULT(S): No significant differences were seen regarding positive hCG/ET rate (48% and 48%), ongoing pregnancy rate (26% and 33%), delivery rate (24% and 31%), and rate of early pregnancy loss (21% and 17%) between the GnRHa and 10,000 IU hCG groups, respectively.
CONCLUSION(S): A small bolus of hCG in the GnRHa group secured the luteal phase, resulting in a comparable reproductive outcome in the two groups. However, a nonsignificant difference of 7% in delivery rates justifies further studies to refine the use of GnRHa for ovulation induction.
前瞻性评估 GnRH 激动剂(GnRHa)诱导排卵后取卵日给予小剂量 hCG 对妊娠结局的影响。
前瞻性、随机试验。
三家医院的 IVF 诊所。
305 例接受 GnRH 拮抗剂方案的 IVF/卵胞浆内单精子注射患者。
取卵日给予 10000IU hCG 或 0.5mg GnRHa(布舍瑞林)加用 1500IU hCG 进行排卵诱导。
两组的生殖结局。
GnRHa 组和 10000IU hCG 组的 hCG/ET 阳性率(分别为 48%和 48%)、持续妊娠率(分别为 26%和 33%)、分娩率(分别为 24%和 31%)和早期妊娠丢失率(分别为 21%和 17%)差异均无统计学意义。
GnRHa 组小剂量 hCG 可维持黄体期,两组的生殖结局相当。然而,分娩率 7%的差异无统计学意义,需要进一步研究以优化 GnRHa 在排卵诱导中的应用。