Repromed, 180 Fullarton Road, Dulwich, SA 5065, Australia.
Hum Reprod. 2010 May;25(5):1219-24. doi: 10.1093/humrep/deq059. Epub 2010 Mar 9.
The use of GnRH antagonists in IVF treatment has many advantages over agonist long down-regulation, yet its uptake has been hampered by an inability to program the start date for gonadotrophin stimulation so as to minimize weekend oocyte retrievals (ORs). In this study, we retrospectively analyzed whether conducting a strict Monday to Friday OR program impacts on IVF outcomes.
A total of 1642 non-programmed IVF antagonist cycles were analyzed to determine if advancing or delaying the OR by 1 day from 'ideal' to avoid Saturday or Sunday OR, respectively, had any impact on IVF outcomes. The IVF outcomes of Tuesday to Thursday served as a control as no modification in OR timing was required on these days.
Advancing the OR by 1 day from the ideal resulted in a small but significant decrease in the number of oocytes collected and embryos created. Delaying the OR by 1 day from ideal resulted in a small increase in the number of oocytes collected and embryos created. However, deviation from the ideal day of OR had no significant effect on live birth rates.
It is possible to safely avoid weekend ORs during GnRH antagonist cycles by simply advancing an ideal Saturday OR to Friday, and delaying an ideal Sunday OR to Monday, without adversely impacting on IVF live birth outcomes.
在 IVF 治疗中使用 GnRH 拮抗剂比激动剂长降调节有许多优势,但由于无法安排促性腺激素刺激的开始日期,以尽量减少周末取卵(OR),其应用受到了阻碍。在这项研究中,我们回顾性分析了严格执行周一至周五取卵方案是否会对 IVF 结局产生影响。
分析了 1642 例非计划 IVF 拮抗剂周期,以确定将 OR 提前或推迟 1 天,分别避免周六或周日取卵,是否会对 IVF 结局产生任何影响。周二至周四的 IVF 结局作为对照,因为这些天不需要对取卵时间进行任何修改。
将 OR 提前 1 天从理想时间进行,会导致采集的卵子数量和形成的胚胎数量略有减少,但具有统计学意义。将 OR 从理想时间推迟 1 天进行,会导致采集的卵子数量和形成的胚胎数量略有增加。然而,偏离理想的取卵日并没有对活产率产生显著影响。
通过简单地将理想的周六取卵提前至周五,并将理想的周日取卵推迟至周一,就可以在 GnRH 拮抗剂周期中安全地避免周末取卵,而不会对 IVF 活产结局产生不利影响。