Boulieu D, Mignon I, Mathieu C, Guérin J F, Lornage J, Pinatel M C
Clinique Gynécologique, Université Claude-Bernard, Faculté A. Carrel, Hôpital Edouard-Herriot, Lyon.
Rev Fr Gynecol Obstet. 1988 May;83(5):309-14.
The development of GnRH analogues enabling a hypophyseal desensitization with suppression of the gonadotrophic activity has opened new therapeutic possibilities in early puberty of central origin, metastatic prostate and breast cancers, endometriosis, fibromyomas and the syndrome of polycystic ovaries. This retrospective study concerning 93 cycles of in vitro fertilization between March and June 1987, compares the results of the combination of a GnRH agonist (busereline 0.3 mg s.c. x 2 days) with HMGs according to a "long protocol" or a "short protocol". For a mean stimulation time by HMG equivalent (13 days), the number of HMG vials is higher in case of a long protocol (40 vs 30). The mean estradiol level, on the morning of the induction is identical (2,096 pg/ml), as well as the mean number of ovocytes collected (6/tap). The segmentation rate appears to be better in case of long protocol (70% vs 45% in female indications), but there is no significant difference between the pregnancy rates (20 to 30%). The short protocol, less costly and simpler, seems therefore interesting in FIV, with patients without SOPK.
促性腺激素释放激素（GnRH）类似物的发展使得通过抑制促性腺活性实现垂体脱敏成为可能，这为中枢性早熟、转移性前列腺癌和乳腺癌、子宫内膜异位症、子宫肌瘤以及多囊卵巢综合征开辟了新的治疗途径。这项回顾性研究涉及1987年3月至6月间的93个体外受精周期，比较了根据“长方案”或“短方案”将GnRH激动剂（布舍瑞林0.3毫克皮下注射，共2天）与促性腺激素（HMGs）联合使用的结果。在等效HMG平均刺激时间（13天）下，长方案的HMG瓶数更多（40瓶对30瓶）。诱导当天早晨的平均雌二醇水平相同（2096皮克/毫升），采集的卵母细胞平均数量也相同（每次穿刺6个）。长方案的分裂率似乎更高（女性适应症中为70%对45%），但妊娠率之间无显著差异（20%至30%）。因此，对于无垂体-卵巢轴功能障碍（SOPK）的患者，短方案成本更低且更简单，在体外受精中似乎很有意义。
