Guivarc'h-Levêque A, Arvis P, Bouchet J-L, Broux P-L, Moy L, Priou G, Vialard J, Colleu D
Clinique mutualiste La Sagesse, Rennes, France.
Gynecol Obstet Fertil. 2010 Jan;38(1):18-22. doi: 10.1016/j.gyobfe.2009.04.028.
Assess the efficiency of estradiol programming in In Vitro Fertilization (IVF) with antagonists by comparing with classical long luteal agonist protocol.
It is a prospective randomized study, comparing 426 cycles in the arm estradiol antagonist with 412 cycles in the arm long agonist. Estradiol 4 mg/day begins on the 25th day of the previous cycle and continues during the menses until the first day of the stimulation which is from Thursday to Sunday whatever the beginning of the menses. The luteal protocol use Decapeptyl 0,1mg which begins on the 20th day of the previous cycle.
Our two populations are similar. No pick-up has been done on Sunday. We have got significantly less oocytes and embryos in estradiol-antagonist (6,8+/-5,3 vs 7,6+/-5,7) and (3,7+/-3,2 vs 4,1+/-3,6) respectively. The ongoing pregnancy rate is comparable in the two groups: 28,6 % for estradiol antagonist 27,9 % for agonist for the whole population and 37 % vs 34,8 % respectively when at least one top embryo was transferred.
Programming antagonist cycles with estradiol allows the organization of the center; it is easy to implement and seems to give results as good as a long agonist protocol.
通过与经典的长效黄体激动剂方案比较，评估在体外受精（IVF）中使用拮抗剂时雌二醇预处理方案的有效性。
这是一项前瞻性随机研究，比较了426个使用雌二醇拮抗剂方案的周期和412个使用长效激动剂方案的周期。从上个周期的第25天开始每天服用4毫克雌二醇，并在月经期间持续服用，直至刺激的第一天，无论月经何时开始，刺激均在周四至周日进行。黄体期方案使用0.1毫克的曲普瑞林，从上个周期的第20天开始。
我们的两组人群相似。周日未进行取卵。在雌二醇拮抗剂组中获得的卵母细胞和胚胎明显较少，分别为（6.8±5.3个 vs 7.6±5.7个）和（3.7±3.2个 vs 4.1±3.6个）。两组的持续妊娠率相当：总体人群中，雌二醇拮抗剂组为28.6%，激动剂组为27.9%；当至少移植一枚优质胚胎时，分别为37%和34.8%。
用雌二醇对拮抗剂周期进行预处理便于中心的安排；易于实施，且似乎能产生与长效激动剂方案一样好的结果。
