Petanovski Zoranco, Dimitrov Gligor, Aydin Byrol, Hadzi-Lega Makjuli, Sotirovska Valentina, Suslevski Damjan, Saltirovski Stefan, Matevski Vladimir, Stojkovska Snezana, Lazarova Ana, Petanovska Emilija, Balkanov Trajan
IVF Centre - First Private General Hospital - ReMedika, Skopje, Republic of Macedonia.
Med Arh. 2011;65(3):153-6. doi: 10.5455/medarh.2011.65.153-156.
The aim of this study was to make a conclusion about aplicability of two differnet gonadothropins in COS (rFSH versus HP-hMG). The primary conclusion for the success as a result of COS are the mean number of retrived oocytes, mature oocytes, fertilization rate, mean number of quality embrios, and criopreverzed embrios. The secondary conclusions were clinical pregnancy rate and delivery rates.
The study was a retrospective case-control study,. A total of 1238 fresh, non donor, IVF cycles with COS were analyzed, but to minimize the bias, only the first cycle for each patient below 40 yaears old, in that period was analyzed. This selection composed the group of respondents that was analyzed which in total amounted to 760 patients.( rFSH = 422, HP-hMG = 338). The patients underwent COS by long luteal protocol using two differnt inducers of COS (rFSH and HP-hMG).
The average starting dose of rFSH used was significantely lower (152.7 +/- 41.1IU), whereas with HMG it was (228.8 +/- _68.7 IU, p=000000). The average number of IU gonadothropin used in therapy, statistically highly is significantly lower when r- FSH is used as an inducer. (1639.2 +/- 476.9 IU, rFSH vs 2356.4 +/- 955.1 IU, HP-hMG, p <0.001). We received significantly higher average number of oocytes and mature oocytes in the group of r-FSH (oocytes; rFSH v HP-hMG-11.8 +/- 7.1 v 10.7 +/- 6.5, p = 0.028 ; mature oocytes: rFSH v HP-hMG 9.9 +/- 6.2 v8.7 +/- 5.5 p = 0.009). However, we did not find a significant difference in the use of the COS inductors regarding the clinical pregnancy rate (rFSH v HP-hMG 49.5% vs 48.9% p=0.92) and delivery rate (rFSH vs HP-hMG 42.9% vs 43.4% p=0.96).CONCLUSIONSs: Our study showed that rFSH is more powerful and more applicable in individualized dosing then HP-hMG and brings better results from COS (more oocytes, more matured oocytes).
本研究的目的是就两种不同促性腺激素在控制性卵巢刺激（COS）中的适用性得出结论（重组促卵泡素与高纯度人绝经期促性腺激素）。COS成功的主要结论是回收的卵母细胞平均数、成熟卵母细胞数、受精率、优质胚胎平均数和冷冻保存胚胎数。次要结论是临床妊娠率和分娩率。
本研究为回顾性病例对照研究。共分析了1238个进行COS的新鲜、非供体体外受精周期，但为尽量减少偏差，仅分析了该时期内40岁以下每位患者的第一个周期。这种选择构成了被分析的应答者组，总计760例患者（重组促卵泡素组 = 422例，高纯度人绝经期促性腺激素组 = 338例）。患者采用长黄体期方案，使用两种不同的COS诱导剂（重组促卵泡素和高纯度人绝经期促性腺激素）进行COS。
使用的重组促卵泡素平均起始剂量显著更低（152.7 +/- 41.1国际单位），而高纯度人绝经期促性腺激素的起始剂量为（228.8 +/- 68.7国际单位，p = 0.000000）。当使用重组促卵泡素作为诱导剂时，治疗中使用的促性腺激素国际单位平均数在统计学上显著更低。（1639.2 +/- 476.9国际单位，重组促卵泡素组对比高纯度人绝经期促性腺激素组2356.4 +/- 955.1国际单位，p <0.001）。在重组促卵泡素组中，我们获得的卵母细胞和成熟卵母细胞平均数显著更高（卵母细胞：重组促卵泡素组对比高纯度人绝经期促性腺激素组 - 11.8 +/- 7.1对比10.7 +/- 6.5，p = 0.028；成熟卵母细胞：重组促卵泡素组对比高纯度人绝经期促性腺激素组9.9 +/- 6.2对比8.7 +/- 5.5，p = 0.009）。然而，在临床妊娠率（重组促卵泡素组对比高纯度人绝经期促性腺激素组49.5%对比48.9%， p = 0.92）和分娩率（重组促卵泡素组对比高纯度人绝经期促性腺激素组42.9%对比43.4%，p = 0.96）方面，我们未发现使用COS诱导剂有显著差异。结论：我们的研究表明，重组促卵泡素在个体化给药方面比高纯度人绝经期促性腺激素更有效且更适用，并且能从COS中带来更好的结果（更多卵母细胞、更多成熟卵母细胞）。
