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当使用促性腺激素释放激素激动剂诱导排卵时,在取卵时给予 1500IU 人绒毛膜促性腺激素可挽救黄体期:一项前瞻性、随机、对照研究。

1,500 IU human chorionic gonadotropin administered at oocyte retrieval rescues the luteal phase when gonadotropin-releasing hormone agonist is used for ovulation induction: a prospective, randomized, controlled study.

机构信息

The Fertility Clinic, Skive Regional Hospital, Resenvej 25, 7800 Skive, Denmark.

出版信息

Fertil Steril. 2010 Feb;93(3):847-54. doi: 10.1016/j.fertnstert.2008.12.042. Epub 2009 Feb 6.

Abstract

OBJECTIVE

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).

DESIGN

Prospective, randomized trial.

SETTING

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.

摘要

目的

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。

设计

前瞻性、随机试验。

地点

三家医院的 IVF 诊所。

患者

305 例接受 GnRH 拮抗剂方案的 IVF/卵胞浆内单精子注射患者。

干预

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。

主要观察指标

两组的生殖结局。

结果

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。

结论

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。

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