Hebisha Sherif A, Aboelazm Banan A, Sallam H N
Alexandria University, Alexandria, Egypt.
J Obstet Gynaecol India. 2017 Aug;67(4):270-274. doi: 10.1007/s13224-016-0952-5. Epub 2016 Nov 29.
Studying the effect of GnRH antagonist administration on the day of hCG to cases of IVF/ICSI with estradiol level above 5000 ng/dl for protection of ovarian hyperstimulation syndrome.
Prospective study.
Sixty patients undergoing controlled hyperstimulation COH, for IVF/ICSI using long agonist and E2 level on the day of hCG, are above 5000 ng/dl, 52 patients received single dose of cetrorelix 0.25 mg on the day of hCG, and 8 patients received two doses of 0.25 mg/day cetrorelix started one day before the day of hCG.
There was no significant difference regarding patients BMI, number of stimulation days, recombinant FSH dose, and number of retrieved oocytes. Clinical pregnancy rate was 76.6% (46/60), in patients received single dose of antagonist PR were significantly higher 80.7% (42/52) versus 50% (4/8) in patients received two doses = 0.047. Live birth rate was 50% (30/60), abortion rate was 20% (12/60), and preterm delivery was 20% (12/60). Mean E2 was 6853.2 ng/dl. Six patients developed moderate ovarian hyperstimulation OHSS (6/60) 10% and no cases of severe OHSS.
GnRH antagonist administration on the day of hCG in cases undergoing IVF/ICSI with long agonist protocol is effective in protection of OHSS and does not affect the clinical pregnancy rate nor live birth rate.
研究在人绒毛膜促性腺激素（hCG）日给予GnRH拮抗剂对体外受精/卵胞浆内单精子注射（IVF/ICSI）且雌二醇水平高于5000 ng/dl的患者预防卵巢过度刺激综合征的效果。
前瞻性研究。
60例接受控制性卵巢刺激（COH）以进行IVF/ICSI的患者，使用长效激动剂方案且hCG日的雌二醇水平高于5000 ng/dl，52例患者在hCG日接受单次剂量0.25 mg的西曲瑞克，8例患者在hCG日前一天开始接受每日两次、每次0.25 mg的西曲瑞克。
患者的体重指数（BMI）、刺激天数、重组促卵泡生成素（FSH）剂量及回收的卵母细胞数量方面无显著差异。临床妊娠率为76.6%（46/60），接受单次剂量拮抗剂的患者临床妊娠率显著更高，为80.7%（42/52），而接受两次剂量的患者为50%（4/8）（P = 0.047）。活产率为50%（30/60），流产率为20%（12/60），早产率为20%（12/60）。平均雌二醇水平为6853.2 ng/dl。6例患者发生中度卵巢过度刺激（OHSS）（6/60），占10%，无重度OHSS病例。
在采用长效激动剂方案进行IVF/ICSI的患者中，于hCG日给予GnRH拮抗剂对预防OHSS有效，且不影响临床妊娠率和活产率。
