Karakaş Yılmaz Nafiye, Kara Mustafa, Hançerlioğulları Necati, Erkılınç Selçuk, Coşkun Buğra, Sargın Ayla, Erkaya Salim
University of Health Sciences, Zekai Tahir Burak Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey.
Bozok University Faculty of Medicine, Department of Obstetrics and Gynecology, Yozgat, Turkey.
Turk J Obstet Gynecol. 2018 Dec;15(4):217-221. doi: 10.4274/tjod.73603. Epub 2019 Jan 9.
To evaluate clinical pregnancy rates, miscarriage rates, ongoing pregnancy rates, and in vitro fertilization-intra cytoplasmic sperm injection outcomes of gonadotropin releasing hormone agonist (GnRHa) administration compared with human chorionic gonadotropin (hCG) application for luteal phase support.
A total of 456 patients were included in the study. The patients were divided into two groups according to luteal phase support type: in group 1 (n=158), single-dose triptorelin acetate 0.1 mg was given on the sixth day after the oocyte pick-up (OPU). In group 2 (n=298), hCG 1500 IU was given on day 4, 7 and 10 after the OPU.
Both groups were homogeneous in relation with age and antral follicle count. The number of stimulation days and endometrial thickness on hCG day (mm) were found to be significantly higher in group 2 than in group 1 (p<0.001). The clinical pregnancy rate was slightly higher in the GnRHa group, but this difference was not statistically significant.
Although there was no statistically significant difference between the two groups, luteal phase support with single-dose GnRHa might be as efficient as three doses of hCG. Large prospective, randomized-controlled studies are required comparing GnRHa and hCG for luteal phase support.
评估与应用人绒毛膜促性腺激素(hCG)进行黄体期支持相比,给予促性腺激素释放激素激动剂(GnRHa)后的临床妊娠率、流产率、持续妊娠率以及体外受精-卵胞浆内单精子注射结局。
本研究共纳入456例患者。根据黄体期支持类型将患者分为两组:第1组(n = 158),在取卵(OPU)后第6天给予0.1 mg单剂量醋酸曲普瑞林。第2组(n = 298),在OPU后第4、7和10天给予1500 IU hCG。
两组在年龄和窦卵泡计数方面具有同质性。发现第2组的刺激天数和hCG日的子宫内膜厚度(mm)显著高于第1组(p < 0.001)。GnRHa组的临床妊娠率略高,但这种差异无统计学意义。
虽然两组之间无统计学显著差异,但单剂量GnRHa进行黄体期支持可能与三剂量hCG一样有效。需要开展大型前瞻性随机对照研究来比较GnRHa和hCG用于黄体期支持的效果。