Yilmaz Saynur, Ozgu-Erdinc A Seval, Yumusak Omer, Kahyaoglu Serkan, Seckin Berna, Yilmaz Nafiye
Etlik Zubeyde Hanim Women Health Training and Research Hospital, Department of Reproductive Endocrinology and.
Syst Biol Reprod Med. 2015;61(4):228-32. doi: 10.3109/19396368.2015.1037936. Epub 2015 Jun 4.
The aim of this study was to evaluate the reproductive outcome and assisted reproductive technology (ART) outcomes of patients with hypogonadotropic hypogonadism (HH) and to compare the results with male factor (MF) infertility patients. The reproductive outcome of 33 HH patients was evaluated retrospectively and compared with results of 47 patients with mild male factor infertility. For ovulation induction, human menopausal gonadotropin (hMG) was used in HH patients and recFSH was used in MF infertility patients. HH patients were divided into subgroups according to retrieved oocyte numbers and the groups were compared with each other. The main outcome measures were total gonadotropin dose used, duration of stimulation, human chorionic gonadotropin (hCG) day estradiol level and endometrial thickness, oocyte number retrieved, and rate of clinical pregnancy. ART outcomes and cycle characteristics of 33 HH patients were compared with 47 MF infertility patients. There was no difference in age and body mass index (BMI) between the groups, but mean follicle stimulating hormone FSH and luteinizing hormone LH levels were significantly lower in the HH group (p < 0.001). Duration of stimulation was 12.5 ± 2.06 days in the HH patients and 10.08 ± 1.62 days in the MF infertility patients and the difference was significant (p < 0.001). Total gonadotropin dose used was higher in the HH group than the MF infertility group (p < 0.001). However, there were no differences in hCG day estradiol levels, endometrial thickness on hCG day, total oocyte number retrieved, MII oocyte number, and pregnancy rate. In the HH subgroups, patient ages were significantly lower in the >15 oocyte retrieved group. Although patients with HH have a long-term estrogen deficiency, their response to controlled ovarian hyperstimulation treatment is similar to normal women. However, the HH group is heterogeneous and estimating the ovarian reserve before treatment is not always possible in this group.
本研究的目的是评估低促性腺激素性性腺功能减退（HH）患者的生殖结局和辅助生殖技术（ART）结局，并将结果与男性因素（MF）不育患者进行比较。对33例HH患者的生殖结局进行回顾性评估，并与47例轻度男性因素不育患者的结果进行比较。对于促排卵，HH患者使用人绝经期促性腺激素（hMG），MF不育患者使用重组促卵泡生成素（recFSH）。HH患者根据获卵数分为亚组，并对各亚组进行相互比较。主要观察指标为促性腺激素总用量、刺激时间、人绒毛膜促性腺激素（hCG）日雌二醇水平和子宫内膜厚度、获卵数以及临床妊娠率。将33例HH患者的ART结局和周期特征与47例MF不育患者进行比较。两组患者的年龄和体重指数（BMI）无差异，但HH组的平均促卵泡生成素（FSH）和促黄体生成素（LH）水平显著较低（p < 0.001）。HH患者的刺激时间为12.5±2.06天，MF不育患者为10.08±1.62天，差异有统计学意义（p < 0.001）。HH组的促性腺激素总用量高于MF不育组（p < 0.001）。然而，hCG日雌二醇水平、hCG日子宫内膜厚度、总获卵数、MII期卵母细胞数和妊娠率无差异。在HH亚组中，获卵数>15个的组患者年龄显著较低。虽然HH患者存在长期雌激素缺乏，但他们对控制性卵巢过度刺激治疗的反应与正常女性相似。然而，HH组具有异质性，在此组中治疗前评估卵巢储备并非总是可行的。
