Braendle W, Lindner C, Lichtenberg V, Goepel E, Bettendorf G
Abteilung für klinische und experimentelle Endokrinologie, Universitäts-Frauenklinik, Hamburg, FRG.
Hum Reprod. 1989 Nov;4(8 Suppl):121-6. doi: 10.1093/humrep/4.suppl_1.121.
We have found a significant improvement of pregnancy rates after pretreatment with an agonist of gonadotrophin releasing hormone (GnRH-a). The pregnancy rate in patients treated with HMG/HCG was 17% per patient and 5.5% per cycle, in patients treated with buserelin, 25% per patient and 15% per cycle and in the triptorelin group 25% per patient and 22% per cycle. From 740 HMG/HCG cycles without GnRH-a only 66% were sufficient according to the analytical data. In 16% we found a premature LH discharge and in 18% an irregular LH fluctuation during stimulation. It is clear that gonadotrophin stimulation during pituitary suppression provokes a more intense ovarian reaction with respect to the number of follicles, as well as the endocrine activity. There are also some important practical advantages: ovarian stimulation can be started without any respect to a definite time of menstruation or of the cycle. Of further importance is the much greater flexibility in the timing of HCG administration. Finally, it will be favourable for all patients who need ovulation induction, especially for oocyte retrieval for IVF or GIFT, because no cycle has to be cancelled.
我们发现，用促性腺激素释放激素激动剂（GnRH-a）预处理后，妊娠率有显著提高。接受HMG/HCG治疗的患者，每位患者的妊娠率为17%，每个周期为5.5%；接受布舍瑞林治疗的患者，每位患者的妊娠率为25%，每个周期为15%；曲普瑞林组每位患者的妊娠率为25%，每个周期为22%。根据分析数据，在740个未使用GnRH-a的HMG/HCG周期中，只有66%是足够的。在16%的周期中，我们发现促黄体生成素（LH）提前释放，在18%的周期中，刺激期间LH波动不规则。显然，垂体抑制期间的促性腺激素刺激会引发更强烈的卵巢反应，无论是卵泡数量还是内分泌活性方面。还有一些重要的实际优势：卵巢刺激可以在不考虑月经或周期的特定时间的情况下开始。更重要的是，在注射人绒毛膜促性腺激素（HCG）的时间安排上有更大的灵活性。最后，这对所有需要诱导排卵的患者都有利，特别是对于体外受精（IVF）或配子输卵管内移植（GIFT）取卵的患者，因为无需取消任何周期。
