1 Faculté de Médecine, Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
2 Laboratoire d'immunologie, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Reprod Sci. 2017 Sep;24(9):1325-1333. doi: 10.1177/1933719116687659. Epub 2017 Jan 5.
The aim of this study was to assess the progression of pain symptoms during assisted reproductive technology (ART) cycles following administration of GnRH agonist (GnRHa) versus human chorionic gonadotrophin (hCG) triggering.
Observational cohort study.
A tertiary care university hospital in France.
Patients who underwent ART programs.
Between January 01, 2014, and June 31, 2014, 122 cycles were allocated to 2 groups: GnRHa triggering with a scheduled differed embryo transfer (n = 57) or hCG triggering with a fresh embryo transfer (n = 70). Pelvic pain scores were evaluated using a visual analog scale (VAS) with regard to dysmenorrhea, dyspareunia, noncyclic pelvic pain, gastrointestinal, and lower urinary tract pain. The total VAS score was defined as the sum of the scores for the various symptoms. Evaluations were carried out twice: during the synchronization treatment prior to ovarian stimulation and during a final evaluation 3 weeks postretrieval. The data were processed using univariate and multivariate logistic regression models.
Trends for total VAS change (ie, final VAS score - synchronization VAS score).
For both groups, pain increased during the ART procedure. Trends for the total VAS change revealed that the increase in pain was significantly less in the "GnRHa triggering" group compared to the "hCG triggering" group (3.77 ± 7.73 and 6.50 ± 6.57, P < .05, respectively). Multivariate logistic regression indicated that GnRHa triggering was associated with less of an increase in pain compared to hCG triggering (odds ratio = 0.31, 95% confidence interval 0.13-0.71, P < .05).
Compared to hCG, GnRHa triggering limits pain symptom progression in the period immediately after ART.
本研究旨在评估在接受 GnRH 激动剂（GnRHa）与人绒毛膜促性腺激素（hCG）触发后，辅助生殖技术（ART）周期中疼痛症状的进展情况。
观察性队列研究。
法国一家三级保健大学医院。
接受 ART 项目的患者。
2014 年 1 月 1 日至 6 月 31 日期间，122 个周期被分配到 2 个组：GnRHa 触发，计划不同步胚胎转移（n=57）或 hCG 触发，新鲜胚胎转移（n=70）。使用视觉模拟量表（VAS）评估盆腔疼痛评分，包括痛经、性交痛、非周期性盆腔疼痛、胃肠道和下尿路疼痛。总 VAS 评分定义为各种症状评分的总和。在卵巢刺激前的同步治疗期间和取卵后 3 周进行了两次评估。使用单变量和多变量逻辑回归模型处理数据。
总 VAS 变化趋势（即，最终 VAS 评分-同步 VAS 评分）。
对于两组，疼痛在 ART 过程中均增加。总 VAS 变化趋势表明，GnRHa 触发组的疼痛增加明显少于 hCG 触发组（分别为 3.77±7.73 和 6.50±6.57，P<0.05）。多变量逻辑回归表明，GnRHa 触发与 hCG 触发相比，疼痛增加较少（比值比=0.31，95%置信区间 0.13-0.71，P<0.05）。
与 hCG 相比，GnRHa 触发可限制 ART 后即刻疼痛症状的进展。
