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Corifollitropin alfa 用于 IVF 中的卵巢刺激:下体重女性中的一项随机试验。

Corifollitropin alfa for ovarian stimulation in IVF: a randomized trial in lower-body-weight women.

出版信息

Reprod Biomed Online. 2010 Jul;21(1):66-76. doi: 10.1016/j.rbmo.2010.03.019. Epub 2010 Mar 28.

Abstract

In this double-blind, double-dummy, randomized, equivalence trial (Ensure), 396 women weighing 60kg or less who underwent controlled ovarian stimulation prior to IVF or intracytoplasmic sperm injection were randomized in a 2:1 ratio to a single dose of 100mug corifollitropin alfa or daily 150IU recombinant FSH (rFSH) for the first 7days of stimulation in a gonadotrophin-releasing hormone antagonist protocol. The mean +/- SD number of oocytes retrieved per started cycle was 13.3 +/- 7.3 for corifollitropin alfa versus 10.6 +/- 5.9 for rFSH. The estimated treatment difference of +2.5 oocytes (95% CI 1.2-3.9) in favour of corifollitropin alfa (P<0.001) was well within the predefined equivalence margin. The median (range) duration of stimulation was 9 (6-15) days in both groups. In 32.8% of the patients, one injection of corifollitropin alfa was sufficient to reach the human chorionic gonadotrophin criterion. The incidence of moderate and severe ovarian hyperstimulation syndrome was 3.4% for corifollitropin alfa and 1.6% for rFSH. A dose of 100mug corifollitropin alfa offers a simplified treatment option for potential normal responder patients with a lower body weight.

摘要

在这项双盲、双模拟、随机、等效性试验(Ensure)中,396 名体重 60kg 或以下的女性在接受 IVF 或胞浆内精子注射前接受了控制性卵巢刺激,按照 2:1 的比例随机分为两组,一组给予单次 100μg 戈那瑞林α,另一组给予每日 150IU 重组 FSH(rFSH),共 7 天,均采用促性腺激素释放激素拮抗剂方案。起始周期内每例患者平均(SD)取卵数为戈那瑞林α组 13.3(7.3)个,rFSH 组 10.6(5.9)个。戈那瑞林α组比 rFSH 组多取卵 2.5 个(95%CI 1.2-3.9),估计治疗差异有统计学意义(P<0.001),且在预先设定的等效性边界内。两组患者的平均(中位数,范围)刺激持续时间均为 9(6-15)天。在 32.8%的患者中,单次注射戈那瑞林α即可达到人绒毛膜促性腺激素标准。戈那瑞林α组和 rFSH 组中中重度卵巢过度刺激综合征的发生率分别为 3.4%和 1.6%。戈那瑞林α 100μg 剂量为体重较轻的潜在正常反应患者提供了简化的治疗选择。

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