Zhou Weiqin, Zhuang Yanyan, Pan Yanping, Xia Fei
Reproductive Medicine Center, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Canglang District, Suzhou, 215006, Jiangsu, China.
Arch Gynecol Obstet. 2017 May;295(5):1269-1275. doi: 10.1007/s00404-017-4353-5. Epub 2017 Mar 29.
To investigate the effects and safety of gonadotropin releasing hormone analogue (GnRH-a) as an addition to progesterone luteal support in women who underwent in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) and achieved a clinical pregnancy.
A retrospective analysis was conducted on 214 patients who underwent IVF/ICSI-ET procedures with standard long mid-luteal protocol, of which 123 received GnRH-a-free protocol and 91 received GnRH-a-added protocol. The patients' pregnancy and delivery course, and their neonates' status at birth and growth/development after birth were statistically compared.
There was no significant difference between both study groups regarding embryo risks and maternal complications during early pregnancy. as well as fetal risks during the middle and late stages and neonate risks during birth, except that the twin pregnancies of the GnRH-a-added group had a considerably greater male/female ratio, and a significantly higher rate of premature delivery and low birth weight than those of the GnRH-a-free group. In addition, there was no significant difference in neonate risks within 2 years after birth between both cohorts.
With precautions taken to control the number of implanted embryos and reduce the incidence of twinning pregnancy, the addition of GnRH-a to luteal support is relatively safe and effective.
探讨促性腺激素释放激素类似物(GnRH-a)添加至黄体酮黄体支持方案中,对接受体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)并实现临床妊娠的女性的效果及安全性。
对214例行IVF/ICSI-ET且采用标准长黄体中期方案的患者进行回顾性分析,其中123例接受无GnRH-a方案,91例接受添加GnRH-a方案。对患者的妊娠和分娩过程,以及其新生儿出生时的状况和出生后的生长/发育情况进行统计学比较。
两个研究组在妊娠早期的胚胎风险和母体并发症方面,以及妊娠中晚期的胎儿风险和出生时的新生儿风险方面均无显著差异,但添加GnRH-a组的双胎妊娠的男女比例显著更高,早产率和低出生体重率显著高于无GnRH-a组。此外,两组在出生后2年内的新生儿风险方面无显著差异。
在采取措施控制植入胚胎数量并降低双胎妊娠发生率的情况下,黄体支持中添加GnRH-a相对安全有效。