de Ziegler D, Frydman R
University of Paris Sud (Bicêtre), Hôpital Antoine Béclère, Clamart, France.
Fertil Steril. 1990 Oct;54(4):682-8. doi: 10.1016/s0015-0282(16)53830-8.
Most oocyte donation programs have experienced higher pregnancy rates than usually seen in regular in vitro fertilization (IVF), suggesting that the quality of either the oocytes or the endometrium is superior. To clarify this issue we analyzed the results of transfers of 136 cryopreserved embryos originating either from donated oocytes (18 transfers) or from regular IVF (118 transfers). Transfers of embryos originating from donated oocytes took place after administrating oral estradiol (E2) valerate and vaginal micronized progesterone (P) following a regimen designed to mimic the serum levels of E2 and P observed during the menstrual cycle. Transfers of embryos originating from regular IVF took place either in the natural cycle (53 transfers) or after suppressing ovarian function with a single injection of a gonadotropin-releasing hormone agonist (GnRH-a), Decapeptyl-Retard 3.75 mg, and administering the same hormone replacement regimen (E2/P) used in oocyte donation (65 transfers). Eighteen transfers involving 24 embryos originating from donated oocytes were affected, resulting in six pregnancies (4 ongoing). The ongoing pregnancy rate per transfer was 22%. Seventy-nine embryos originating from regular IVF were transferred (53 transfers) in the natural cycle resulting in six pregnancies (2 ongoing). One hundred three other embryos originating from regular IVF were transferred (65 transfers) after administration of GnRH-a and E2/P resulting in four pregnancies. The pregnancy rate after transfers of embryos originating from regular IVF was 9% per transfer. This was significantly less than the pregnancy rate of 33% per transfer seen after the transfers of embryos originating from donated oocytes.(ABSTRACT TRUNCATED AT 250 WORDS)
大多数卵母细胞捐赠项目的妊娠率高于常规体外受精(IVF),这表明卵母细胞或子宫内膜的质量更优。为了阐明这一问题,我们分析了136个冷冻胚胎移植的结果,这些胚胎要么来自捐赠的卵母细胞(18次移植),要么来自常规IVF(118次移植)。来自捐赠卵母细胞的胚胎移植在口服戊酸雌二醇(E2)和阴道微粒化孕酮(P)后进行,采用的方案旨在模拟月经周期中观察到的E2和P的血清水平。来自常规IVF的胚胎移植要么在自然周期进行(53次移植),要么在单次注射促性腺激素释放激素激动剂(GnRH-a)、3.75 mg缓释曲普瑞林后抑制卵巢功能,并采用与卵母细胞捐赠相同的激素替代方案(E2/P)(65次移植)。涉及来自捐赠卵母细胞的24个胚胎的18次移植受到影响,产生了6次妊娠(4次持续妊娠)。每次移植的持续妊娠率为22%。来自常规IVF的79个胚胎在自然周期中进行了移植(53次移植),产生了6次妊娠(2次持续妊娠)。在给予GnRH-a和E2/P后,来自常规IVF的另外103个胚胎进行了移植(65次移植),产生了4次妊娠。来自常规IVF的胚胎移植后的妊娠率为每次移植9%。这明显低于来自捐赠卵母细胞的胚胎移植后每次移植33%的妊娠率。(摘要截短于250字)