Gong Fei, Li Xihong, Zhang Shunji, Ma Hainan, Cai Sufen, Li Juan, Lin G E, Lu Guangxiu
Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha, Hunan 410083, P.R. China ; Department of Reproductive Medicine, Reproductive and Genetic Hospital of Citic-Xiangya, Changsha, Hunan 410078, P.R. China ; Key Laboratory of Human Stem Cell & Reproductive Engineering, Ministry of Health, Changsha, Hunan 410008, P.R. China.
Department of Reproductive Medicine, Reproductive and Genetic Hospital of Citic-Xiangya, Changsha, Hunan 410078, P.R. China.
Exp Ther Med. 2015 Nov;10(5):1865-1870. doi: 10.3892/etm.2015.2769. Epub 2015 Sep 23.
There are currently various protocols for in vitro fertilization (IVF). For patients with polycystic ovarian syndrome (PCOS), an optimized protocol for the downregulation of pituitary follicle stimulating hormone and luteinizing hormone via gonadotropin-releasing hormone agonist (GnRHa) remains a challenge. In the present study, the primary endpoint of an ultra-long and a conventional long GnRHa protocol for intracytoplasmic sperm injection/IVF treatments of patients with PCOS was retrospectively compared. In the modified ultra-long protocol group, endometrial thickness, morphology, and blood flow were significantly improved, as compared with in the conventional long protocol group. Furthermore, the serum progestogen (P) concentrations and P/estrogen (E2) [(Px1,000/E2)] ratio on the day of human chorionic gonadotrophin administration were significantly decreased in the modified ultra-long downregulation group, whereas the pregnancy and implantation rates were significantly higher. There were no significant differences in the average number of obtained oocytes, good quality embryo rates, cancel rates, fertilization rates, abortion rates, serious ovarian hyperstimulation syndrome incidences, ectopic pregnancy rates or gonadotropin (Gn) dosages between the two groups. These results suggest that the modified ultra-long protocol plus human menopausal Gn medication may be superior to the conventional long protocol, and may lead to improved implantation and pregnancy outcomes for infertile patients with PCOS.
目前有多种体外受精（IVF）方案。对于多囊卵巢综合征（PCOS）患者，通过促性腺激素释放激素激动剂（GnRHa）下调垂体促卵泡激素和促黄体生成素的优化方案仍是一项挑战。在本研究中，对超长方案和传统长方案GnRHa用于PCOS患者卵胞浆内单精子注射/IVF治疗的主要终点进行了回顾性比较。与传统长方案组相比，改良超长方案组的子宫内膜厚度、形态和血流均有显著改善。此外，改良超长下调组在人绒毛膜促性腺激素给药当天的血清孕激素（P）浓度和P/雌激素（E2）[（P×1,000/E2）]比值显著降低，而妊娠率和着床率显著更高。两组之间获得的平均卵母细胞数、优质胚胎率、取消率、受精率、流产率、严重卵巢过度刺激综合征发生率、异位妊娠率或促性腺激素（Gn）剂量均无显著差异。这些结果表明，改良超长方案加人绝经后促性腺激素用药可能优于传统长方案，并可能改善PCOS不孕患者的着床和妊娠结局。
