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去氧孕烯与拮抗剂注射抑制供卵周期 LH:一项交叉研究。

Desogestrel versus antagonist injections for LH suppression in oocyte donation cycles: a crossover study.

机构信息

Reproductive Medicine Service, Hospital Universitari Dexeus, Barcelona, Spain.

出版信息

Gynecol Endocrinol. 2019 Oct;35(10):878-883. doi: 10.1080/09513590.2019.1604661. Epub 2019 May 7.

DOI:10.1080/09513590.2019.1604661
PMID:31062995
Abstract

To study whether ovarian response to corifollitropin among oocyte donors (OD) is different when oral desogestrel (DSG) is used to block the luteinizing hormone (LH) surge when compared to GnRH-antagonist use. This is a retrospective, cohort study at a private, university-based, IVF center including 35 OD. Patients underwent two stimulation cycles under corifollitropin alfa (CFT), one under an antagonist and another under DSG, between February 2015 and May 2017. In antagonist cycles, daily ganirelix was administered since a leading follicle reached 14 mm. In the DSG cycles, daily oral DSG was prescribed. The main outcome measure was oocytes retrieved. Compared to antagonist cycles, cycles under DSG received fewer injections (10.3 ± 2.8 5.0 ± 2.1,  < .001), nominally lower total supplementary gonadotropin dose (497.4 ± 338.9I U 442.9 ± 332.8 IU, =.45) with a lower total cost of medication (1018.6 ± 191.0€ 813.8 ± 145.9€, <.001). There were no differences in the total number of retrieved oocytes between groups (17.4 ± 7.5 18.6 ± 8.9, =.34). In the corresponding oocyte recipients, clinical pregnancy rate was similar between groups: 52.0% 58.6%, respectively (=.78). ODs' stimulation's response under DSG is similar when compared to (17.4 ± 7.5 18.6 ± 8.9, =.34) but associated with less injections and lower medication costs. The main advantage of this strategy is its simplicity, an aspect of utmost importance in the management of ODs.

摘要

研究在促性腺激素释放激素(GnRH)拮抗剂与口服地屈孕酮(DSG)抑制黄体生成素(LH)峰时,卵母细胞捐赠者(OD)对 Corifollitropin 的卵巢反应是否不同。这是一项回顾性队列研究,在一家私人的、以大学为基础的 IVF 中心进行,共纳入 35 名 OD。患者在 2015 年 2 月至 2017 年 5 月期间接受了两次 Corifollitropin alfa(CFT)刺激周期,一次为拮抗剂周期,另一次为 DSG 周期。在拮抗剂周期中,从主导卵泡达到 14mm 开始,每天给予 GnRH 拮抗剂 Ganirelix。在 DSG 周期中,每天口服 DSG。主要结局测量指标为取出的卵母细胞数。与拮抗剂周期相比,DSG 周期接受的注射次数更少(10.3±2.8 5.0±2.1,<0.001),名义上总补充性腺激素剂量较低(497.4±338.9IU 442.9±332.8IU,=.45),药物总成本较低(1018.6±191.0€ 813.8±145.9€,<0.001)。两组总取卵数无差异(17.4±7.5 18.6±8.9,=.34)。在相应的卵母细胞接受者中,两组的临床妊娠率相似:52.0% 58.6%,分别为(=.78)。与对照组相比(17.4±7.5 18.6±8.9,=.34),DSG 下 OD 刺激反应相似,但注射次数较少,药物费用较低。这种策略的主要优点是其简单性,这在 OD 管理中非常重要。

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