Luo Shan, Li Shangwei, Li Xiaohong, Bai Yu, Jin Song
Division of Reproductive Medical Center, West China Second University Hospital of Sichuan University , Sichuan , China.
Gynecol Endocrinol. 2014 Apr;30(4):255-9. doi: 10.3109/09513590.2013.863862. Epub 2013 Dec 3.
Polycystic ovary syndrome (PCOS) patients undergoing controlled ovarian stimulation and intrauterine insemination (COS/IUI) often face the risk of premature luteinization, which may result in lower pregnancy rate and higher miscarriage rate. This review was performed to identify if adjuvant treatment with GnRH antagonist (GnRH-ant) could effectively improve the clinical outcome of patients with PCOS undergoing COS/IUI. A literature search was conducted on the PubMed, EMBASE and Cochrane library databases. Two randomized controlled trials were included in this review, enrolling a total of 333 cycles. The patients who received GnRH-ant treatment had lower progesterone levels on the hCG day and a reduced premature luteinization rate. However, the rates of live birth, clinical pregnancy and miscarriage did not significantly differ between the GnRH-ant supplementation group and control group. In conclusion, although the existing randomized controlled trials indicate that GnRH-ant can effectively decrease the premature luteinizaton rate, evidence to support its use to improve clinical pregnancy outcomes in PCOS patients undergoing COS/IUI treatment is insufficient.
接受控制性卵巢刺激和宫内人工授精（COS/IUI）的多囊卵巢综合征（PCOS）患者常常面临过早黄素化的风险，这可能导致较低的妊娠率和较高的流产率。本综述旨在确定使用促性腺激素释放激素拮抗剂（GnRH-ant）进行辅助治疗是否能有效改善接受COS/IUI的PCOS患者的临床结局。我们在PubMed、EMBASE和Cochrane图书馆数据库中进行了文献检索。本综述纳入了两项随机对照试验，共纳入333个周期。接受GnRH-ant治疗的患者在注射人绒毛膜促性腺激素（hCG）当天的孕酮水平较低，过早黄素化率降低。然而，GnRH-ant补充组和对照组之间的活产率、临床妊娠率和流产率并无显著差异。总之，尽管现有的随机对照试验表明GnRH-ant可有效降低过早黄素化率，但支持其用于改善接受COS/IUI治疗的PCOS患者临床妊娠结局的证据并不充分。
