Testart J, Belaisch-Allart J, Forman R, Gazengel A, Strubb N, Hazout A, Frydman R
Unité 187, INSERM, Clamart, France.
Hum Reprod. 1989 Feb;4(2):192-7. doi: 10.1093/oxfordjournals.humrep.a136870.
A retrospective analysis was performed in order to compare the number and quality of oocytes recovered in in-vitro fertilization cycles according to different protocols for ovarian stimulation. Treatments including a gonadotrophin-releasing hormone agonist (GnRHa), either decapeptyl or buserelin, were associated with the recovery of more oocytes (6.0-7.2%) than treatments without GnRHa (3.7-4.8%). However, the mean number of normal embryos per patient yielding oocyte(s) was comparable between cycles stimulated with or without GnRHa (2.4-2.7), except in those cycles programmed with norethisterone and gonadotrophins (1.7). There was no difference in the rates of immature or atretic oocytes between stimulation treatments. Following clomiphene and human menopausal gonadotrophin treatment there was a lower rate of fractured zona oocytes, higher rates of fertilization and normal growth of fertilized eggs than after any other treatment. The proportion of normal embryos per recovered oocyte was inversely related to the degree of ovarian response in most of the stimulation treatments. Most of the abnormal embryos contained more than two pronuclei in cycles without GnRHa administration and exhibited polynucleated blastomeres in cycles treated with buserelin or decapeptyl. In conclusion, the use of GnRHa and gonadotrophins for ovarian stimulation increased the mean number of recovered oocytes, but did not increase the mean number of embryos able to develop.
为了比较根据不同卵巢刺激方案在体外受精周期中回收的卵母细胞数量和质量，进行了一项回顾性分析。使用促性腺激素释放激素激动剂（GnRHa）（曲普瑞林或布舍瑞林）的治疗组回收的卵母细胞比未使用GnRHa的治疗组更多（6.0 - 7.2%对比3.7 - 4.8%）。然而，每个产生卵母细胞的患者的正常胚胎平均数量在使用或未使用GnRHa刺激的周期之间相当（2.4 - 2.7），除了那些使用炔诺酮和促性腺激素方案的周期（1.7）。刺激治疗之间未成熟或闭锁卵母细胞的比率没有差异。与任何其他治疗后相比，克罗米芬和人绝经期促性腺激素治疗后卵裂球破裂的卵母细胞比率更低，受精率和受精卵正常生长率更高。在大多数刺激治疗中，每个回收卵母细胞的正常胚胎比例与卵巢反应程度呈负相关。在未使用GnRHa的周期中，大多数异常胚胎含有两个以上原核，在用布舍瑞林或曲普瑞林治疗的周期中表现出多核卵裂球。总之，使用GnRHa和促性腺激素进行卵巢刺激增加了回收卵母细胞的平均数量，但并未增加能够发育的胚胎平均数量。
