Riss P, Reinthaller A, Fischl F, Deutinger J, Müller-Tyl E, Lasnik E
II. Universitäts-Frauenklinik, Wien.
Geburtshilfe Frauenheilkd. 1989 May;49(5):448-51. doi: 10.1055/s-2008-1036400.
Gonadotropin releasing hormone (GnRH) agonists can induce a hypogonadotropic state. We studied the effect of a long acting GnRH agonist on pituitary gonadotropin levels, the pattern of serum steroid levels in subsequent cycle stimulation, and whether such a protocol can improve the results of an in-vitro fertilization (IVF) program. 29 patients with tubal factor from our IVF program received 4 mg Decapeptyl CR intramuscularly and were subsequently stimulated with FSH/HMG/HCG (Group I). 35 patients were stimulated according to our standard protocol with HMG/HCG (Group II). After a single injection of Decapeptyl CR, serum levels of LH, FSH and E2 fell to more than half of pretreatment levels. In the subsequent cycle stimulation the gonadotropin dosage was increased threefold compared with the control group. In group I, progesterone levels were significantly higher. Though more oocytes were retrieved in group I, fertilization rates were significantly lower. After Decapeptyl and the subsequent stimulation, we observed short rises in urinary LH in 22/29 patients. In our experience, a single intramuscular injection of Decapeptyl resulted in sufficient pituitary suppression, however, we could not see an improvement in the results after IVF.
促性腺激素释放激素（GnRH）激动剂可诱导性腺功能减退状态。我们研究了长效GnRH激动剂对垂体促性腺激素水平的影响、后续周期刺激中血清类固醇水平的模式，以及这样的方案是否能改善体外受精（IVF）程序的结果。我们IVF程序中的29例输卵管因素患者肌肉注射4mg曲普瑞林缓释剂，随后用促卵泡激素/人绝经期促性腺激素/人绒毛膜促性腺激素进行刺激（第一组）。35例患者根据我们的标准方案用人绝经期促性腺激素/人绒毛膜促性腺激素进行刺激（第二组）。单次注射曲普瑞林缓释剂后，促黄体生成素、促卵泡激素和雌二醇的血清水平降至预处理水平的一半以上。在随后的周期刺激中，促性腺激素剂量与对照组相比增加了两倍。在第一组中，孕酮水平显著更高。虽然第一组回收的卵母细胞更多，但受精率显著更低。在使用曲普瑞林及随后的刺激后，我们观察到29例患者中有22例尿促黄体生成素短暂升高。根据我们的经验，单次肌肉注射曲普瑞林可导致充分的垂体抑制，然而，我们并未看到IVF结果有所改善。
