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在人工周期冻融胚胎移植中添加单次 GnRH 激动剂对黄体支持的影响:一项随机临床试验。

The addition of single dose GnRH agonist to luteal phase support in artificial cycle frozen embryo transfer: a randomized clinical trial.

机构信息

a Chongqing Maternity and Children Health Care Hospital , Institute of Genetics and Reproduction , Chongqing , P.R. China.

出版信息

Gynecol Endocrinol. 2019 Jul;35(7):618-622. doi: 10.1080/09513590.2018.1563888. Epub 2019 Jan 31.

Abstract

This prospective randomized clinical trial (RCT) was to evaluate the effect of single-dose gonadotrophin-releasing hormone agonist (GnRHa) in artificial cycle frozen-embryo transfer (AC-FET). A total of 868 FET cycles were included and randomized into two groups: Group A ( = 434) received GnRHa 0.1 mg subcutaneous injection on day 3 after embryo transfer (ET); Group B ( = 434) did not receive GnRHa. The demographic characteristics, primary endpoint (implantation rate) and secondary endpoints (chemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate) were compared between two groups and subgroups (aged <35 years and 35-37 years). There were no significant differences in terms of the rates of implantation, clinical pregnancy, ongoing pregnancy, and miscarriage between two groups. While, the subgroups analysis showed the implantation rate was significantly increased in advanced age women (35-37 years) in GnRHa group compared with control group (45.3% vs. 27.8% = .03). In conclusion, single dose of GnRHa (0.1 mg triptorelin acetate) supplementation 3 days after ET in AC-FET cycles did not show significant benefit on pregnancy outcomes as a whole. However, in ageing women subgroup, the implantation rate was increasing by adding up GnRHa in peri-implantation periods, and this tendency needs to be further demonstrated by RCT with larger sample size.

摘要

这项前瞻性随机临床试验(RCT)旨在评估单次剂量促性腺激素释放激素激动剂(GnRHa)在人工周期冻融胚胎移植(AC-FET)中的作用。共有 868 个 FET 周期被纳入并随机分为两组:A 组(n=434)在胚胎移植后(ET)第 3 天接受 0.1mg 皮下注射 GnRHa;B 组(n=434)未接受 GnRHa。比较两组和亚组(年龄<35 岁和 35-37 岁)的人口统计学特征、主要终点(着床率)和次要终点(生化妊娠率、临床妊娠率、持续妊娠率)。两组间着床率、临床妊娠率、持续妊娠率和流产率无显著差异。然而,亚组分析显示,在 GnRHa 组中,年龄较大的(35-37 岁)女性的着床率明显高于对照组(45.3%比 27.8%,P=0.03)。总之,在 AC-FET 周期中,ET 后 3 天单次给予 GnRHa(0.1mg 醋酸曲普瑞林)补充剂量并未整体上显示出对妊娠结局的显著益处。然而,在高龄女性亚组中,在着床期添加 GnRHa 可提高着床率,这一趋势需要进一步通过更大样本量的 RCT 来证明。

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