Reproductive Endocrinology-IVF Department, Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
Arch Gynecol Obstet. 2013 May;287(5):1039-44. doi: 10.1007/s00404-012-2673-z. Epub 2012 Dec 13.
In recent years, it has become evident that ovarian stimulation, although a central component of in vitro fertilization (IVF), may itself has detrimental effects on oogenesis, embryo quality, endometrial receptivity, and perhaps also perinatal outcomes.
To evaluate the effect of higher gonadotrophin dose on clinical pregnancy rate in normo-responder ICSI cycles with long protocol.
A retrospective study was planned in the Department of Reproductive Endocrinology of Zekai Tahir Burak Women's Health Education and Research Hospital. 362 normo-responders undergoing ICSI cycles with long protocol were included in the study. Group 1 (n = 260): Total gonadotrophin dose <2198 IU and Group 2 (n = 102): Total gonadotrophin dose >2198 IU. Laboratory IVF outcome, clinical pregnancy rate were evaluated.
RESULT(S): There was no statistically significant difference between peak estradiol levels, endometrial thickness, fertilization rates among the Group 1 versus Group 2 (p > 0.05). But there was a statistically significant difference in age, baseline FSH, oocyte number, 2PN, and clinical pregnancy among the Group 1 versus Group 2. Clinical pregnancy rate were significantly higher in Group 1 compared with Group 2 (p < 0.001). Lower gonadotrophin dose, 2PN was an independent positive predictor of clinical pregnancy (OR 2.65 for gonadotrophin dose, OR 1.1 for 2PN) CONCLUSION(S): Higher total gonadotrophin dose adversely affect clinical pregnancy in normo-responder patients undergoing ICSI cycles with long protocol.
近年来，人们已经认识到卵巢刺激虽然是体外受精（IVF）的核心组成部分，但它本身可能对卵母细胞发生、胚胎质量、子宫内膜容受性，甚至围产儿结局产生不利影响。
评估长方案中使用高剂量促性腺激素对正常反应者 ICSI 周期临床妊娠率的影响。
在泽凯·塔希尔·布拉克妇女健康教育和研究医院生殖内分泌科进行了一项回顾性研究。将 362 名接受长方案 ICSI 周期的正常反应者纳入研究。第 1 组（n=260）：总促性腺激素剂量<2198IU；第 2 组（n=102）：总促性腺激素剂量>2198IU。评估实验室 IVF 结局、临床妊娠率。
第 1 组与第 2 组之间的峰值雌二醇水平、子宫内膜厚度、受精率无统计学差异（p>0.05）。但第 1 组与第 2 组之间的年龄、基础 FSH、卵母细胞数、2PN 和临床妊娠率存在统计学差异。第 1 组的临床妊娠率明显高于第 2 组（p<0.001）。较低的促性腺激素剂量、2PN 是临床妊娠的独立阳性预测因子（促性腺激素剂量的 OR 为 2.65，2PN 的 OR 为 1.1）。
在接受长方案 ICSI 周期的正常反应者中，高剂量总促性腺激素会对临床妊娠产生不利影响。
