Clínica Fiv Valencia, Calle Santa Rosa 12, Valencia, Spain.
Reprod Biomed Online. 2012 Feb;24(2):247-50. doi: 10.1016/j.rbmo.2011.11.006. Epub 2011 Nov 20.
This prospective observational study evaluated the efficacy and safety of oocyte-donation cycles triggered with a gonadotrophin-releasing hormone (GnRH) agonist without monitoring oestradiol concentrations during ovarian stimulation. A total of 97 oocyte donors received recombinant FSH (150-225/day) and GnRH antagonists (0.25mg/day). Oocyte maturation was triggered with 0.2mg triptorelin s.c. Donors aged 25.4 ± 4.1 years were stimulated for 8.8 ± 0.9 days and underwent 2.9 ± 0.5 (2-4) ultrasound assessments. Total FSH dose was 1703.4 ± 304.7IU, antagonists were administered for 4.3 ± 1.0 days, 14.7 ± 8.8 oocytes were retrieved and there were no cases of ovarian hyperstimulation syndrome. Recipients (n=123) aged 40.3 ± 3.4 years received 10.9 ± 4.3 oocytes, 88.7% of which were metaphase II. Intracytoplasmic sperm injection fertilization rate was 79% and 2.18 ± 0.6 (1-3) embryos were transferred. The pregnancy, clinical pregnancy and twin pregnancy rates were 64.2%, 57.7% and 19.7%, respectively. In conclusion, given the high efficacy and safety of the GnRH-antagonist protocol triggered with a GnRH agonist, the monitoring of oestradiol concentrations is not necessary. Ultrasound monitoring is enough for an adequate follow up of the stimulation cycle in oocyte donors.
本前瞻性观察研究评估了在卵巢刺激过程中不监测雌二醇浓度而使用 GnRH 激动剂触发卵母细胞捐赠周期的疗效和安全性。共有 97 名卵母细胞捐赠者接受了重组 FSH（150-225/天）和 GnRH 拮抗剂（0.25mg/天）治疗。使用 0.2mg 曲普瑞林皮下注射触发卵母细胞成熟。捐赠者年龄为 25.4±4.1 岁，刺激时间为 8.8±0.9 天，进行了 2.9±0.5（2-4）次超声评估。总 FSH 剂量为 1703.4±304.7IU，拮抗剂使用了 4.3±1.0 天，共取出 14.7±8.8 个卵母细胞，且未发生卵巢过度刺激综合征。接受者（n=123）年龄为 40.3±3.4 岁，接受了 10.9±4.3 个卵母细胞，其中 88.7%为中期 II 期。胞浆内精子注射受精率为 79%，转移了 2.18±0.6（1-3）个胚胎。妊娠率、临床妊娠率和双胞胎妊娠率分别为 64.2%、57.7%和 19.7%。总之，鉴于 GnRH 拮抗剂方案与 GnRH 激动剂触发的高疗效和安全性，无需监测雌二醇浓度。超声监测足以充分随访卵母细胞捐赠者的刺激周期。
