Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia 46015, Spain.
Reprod Biomed Online. 2009 Oct;19(4):486-92. doi: 10.1016/j.rbmo.2009.06.001.
The use of gonadotrophin-releasing hormone (GnRH) agonists for triggering ovulation remains controversial. The primary objective of this study was to evaluate the incidence of ovarian hyperstimulation syndrome (OHSS) following GnRH agonist versus recombinant human chorionic gonadotrophin (HCG) as methods for triggering ovulation. A second aim was to compare the clinical outcome and embryo quality according to the two procedures. The cycle characteristics of 100 oocyte donors undergoing ovarian stimulation and IVF outcomes of their 100 oocyte recipients were analysed. Donors were prospectively randomized into two groups on the last day of ovarian stimulation: Group I received a single bolus of 0.2 mg of triptorelin and Group II received 250 microg of recombinant HCG. No differences were observed in the number of oocytes retrieved or in the proportion of metaphase II oocytes between the groups. The OHSS rate was higher in donors that received recombinant HCG ( P = 0.003). Moreover, there was no significant difference between IVF parameters and outcome in the two groups. In conclusion, a GnRH agonist effectively triggers the final oocyte maturation in oocyte donors without negatively affecting implantation, pregnancy or miscarriage rates. Moreover, this regime effectively eliminates the risk of OHSS in this group of women.
促性腺激素释放激素（GnRH）激动剂在诱发排卵中的应用仍存在争议。本研究的主要目的是评估 GnRH 激动剂与重组人绒毛膜促性腺激素（HCG）作为诱发排卵方法时卵巢过度刺激综合征（OHSS）的发生率。第二个目的是根据两种方法比较临床结局和胚胎质量。分析了 100 名接受卵巢刺激的卵母细胞供体的周期特征及其 100 名卵母细胞受者的 IVF 结果。在卵巢刺激的最后一天，供体被前瞻性随机分为两组：I 组接受 0.2mg 曲普瑞林单次推注，II 组接受 250μg 重组 HCG。两组之间获取的卵母细胞数量或中期 II 卵母细胞的比例无差异。接受重组 HCG 的供体 OHSS 发生率更高（P=0.003）。此外，两组之间的 IVF 参数和结局无显著差异。总之，GnRH 激动剂可有效触发卵母细胞供体的最后一次卵母细胞成熟，而不会对着床、妊娠或流产率产生负面影响。此外，这种方案可有效消除该组妇女发生 OHSS 的风险。
