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对于正常反应患者体外受精失败后应选择何种方案:激动剂方案还是拮抗剂方案?

What should be the protocol selection after failure of in-vitro fertilization at normoresponder patients: Agonist or antagonist?

作者信息

Ceyhan Seyit Temel, Bayoğlu Tekin Yeşim, Sakinci Mehmet, Ercan Cihangir Mutlu, Keskin Uğur

机构信息

Gülhane Military Medical Academy, In-Vitro Fertilization Unite, Ankara, Turkey.

Recep Tayyip Erdoğan University Faculty of Medicine, Department of Gynecology and Obstetrics, Rize, Turkey.

出版信息

Turk J Obstet Gynecol. 2014 Dec;11(4):198-202. doi: 10.4274/tjod.03789. Epub 2014 Dec 15.

Abstract

OBJECTIVE

Evaluation of the impact of agonist or antagonist protocol selection on pregnancy outcomes after failure of in-vitro fertilization (IVF) treatment cycles which were down regulated with Gonadotropin Releasing Hormone (GnRH) agonist.

MATERIALS AND METHODS

This was a retrospective study. Two hundred and sixty nine patients who were treated with GnRH agonist protocol between years 2002-2012 at an IVF unit and underwent a second attempt following one year period after failure of IVF enrolled in the study. Age, basal FSH levels, antral follicle counts, duration of induction, the number of yielded oocytes, the number of transferred embryos and the transfer days, clinical and ongoing pregnancy rates were evaluated for each treatment cycle.

RESULTS

Normoresponder patients were separated into two groups according to the agonist or antagonist protocol selection at the second attempt and the results of two consequent IVF cycles were compared. There were no statistically significant difference between the groups for the dosage of administered gonadotropin, duration of induction, the count of yielded oocytes, the day and the number of transferred embryos (p>0.05). Furthermore the fertilization rate, clinical and ongoing pregnancy rates were similar in two groups.

CONCLUSION

The selection of antagonist treatment is effective as agonist protocols at normoresponder patients after failure of IVF.

摘要

目的

评估激动剂或拮抗剂方案的选择对促性腺激素释放激素(GnRH)激动剂降调节后的体外受精(IVF)治疗周期失败后妊娠结局的影响。

材料与方法

这是一项回顾性研究。2002年至2012年间在一家IVF单位接受GnRH激动剂方案治疗且在IVF失败一年后进行第二次尝试的269例患者纳入研究。对每个治疗周期评估年龄、基础FSH水平、窦卵泡计数、诱导时间、获卵数、移植胚胎数和移植天数、临床妊娠率和持续妊娠率。

结果

正常反应者患者在第二次尝试时根据激动剂或拮抗剂方案的选择分为两组,并比较随后两个IVF周期的结果。两组在促性腺激素给药剂量、诱导时间、获卵数、移植胚胎的日期和数量方面无统计学显著差异(p>0.05)。此外,两组的受精率、临床妊娠率和持续妊娠率相似。

结论

IVF失败后,拮抗剂治疗方案的选择对正常反应者患者与激动剂方案一样有效。

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