Eftekhar Maryam, Bagheri Ramesh Baradaran, Neghab Nosrat, Hosseinisadat Robabe
Reasearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Recurrent Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
JBRA Assist Reprod. 2018 Sep 1;22(3):238-243. doi: 10.5935/1518-0557.20180039.
This study aimed to evaluate the effect of three days of GnRH antagonist pretreatment on the pregnancy outcomes of women with polycystic ovarian syndrome (PCOS) on GnRH antagonist protocols for IVF/ICSI.
Fifty women with PCOS in the control group received conventional antagonist protocols, starting on day 2 of the cycle. In the pretreatment group (n=38), a GnRH antagonist was administered from day 2 of the menstrual cycle for three days.
Controlled ovarian stimulation (COS) duration and gonadotropin dosages were similar in both groups. The number of metaphase II (MII) oocytes, 2PN oocytes, embryos, along with implantation and clinical pregnancy rates, were higher in the pretreatment group when compared with controls, although the increment was not significant (P value ≥0.05). The chemical pregnancy rate was significantly higher in the pretreatment group. The rate of OHSS was significantly lower in the pretreatment than in the control group.
Women with PCOS offered early follicular phase GnRH antagonist pretreatment for three consecutive days had significantly fewer cases of OHSS and higher chemical pregnancy rates. There were trends toward greater numbers of MII oocytes, 2PN oocytes, and embryos, and higher clinical pregnancy rates in the pretreatment group.
本研究旨在评估对接受体外受精/卵胞浆内单精子注射（IVF/ICSI）的促性腺激素释放激素（GnRH）拮抗剂方案的多囊卵巢综合征（PCOS）女性进行三天GnRH拮抗剂预处理对妊娠结局的影响。
对照组的50名PCOS女性从月经周期第2天开始接受常规拮抗剂方案。预处理组（n = 38）从月经周期第2天开始给予GnRH拮抗剂，持续三天。
两组的控制性卵巢刺激（COS）持续时间和促性腺激素剂量相似。与对照组相比，预处理组的中期II（MII）卵母细胞、原核（2PN）卵母细胞、胚胎数量以及着床率和临床妊娠率更高，尽管增幅不显著（P值≥0.05）。预处理组的生化妊娠率显著更高。预处理组的卵巢过度刺激综合征（OHSS）发生率显著低于对照组。
连续三天在卵泡早期对PCOS女性进行GnRH拮抗剂预处理，OHSS病例显著减少，生化妊娠率更高。预处理组的MII卵母细胞、2PN卵母细胞和胚胎数量有增加趋势，临床妊娠率也更高。
