Rutherford A J, Subak-Sharpe R J, Dawson K J, Margara R A, Franks S, Winston R M
Institute of Obstetrics and Gynaecology, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Br Med J (Clin Res Ed). 1988 Jun 25;296(6639):1765-8. doi: 10.1136/bmj.296.6639.1765.
Treatment with buserelin, an agonist of luteinising hormone releasing hormone, and human menopausal gonadotrophin was compared with the conventional treatment of clomiphene citrate and human menopausal gonadotrophin in the outcome of in vitro fertilisation. Seventy seven infertile women had 83 cycles of treatment with buserelin and human menopausal gonadotrophin, and concurrently another 328 infertile women were treated with clomiphene citrate and human menopausal gonadotrophin. Seven (8%) cycles were cancelled owing to inadequate super-ovulation or ovarian hyperstimulation in the women receiving buserelin and 103 (31%) were cancelled because of poor follicular development in those receiving clomiphene citrate. The mean number of oocytes recovered was significantly higher with buserelin (9.5 (SD 4.5) v 5.5 (2.2)) as was the mean number of embryos obtained (4.3 (2.4) v 2.9 (1.7)). Significantly more women who had an embryo transfer became clinically pregnant after treatment with buserelin (53% (30/57) v 30% (48/159), or 36% v 14% of treatment cycles). Altogether 33% (10) of pregnancies in women treated with buserelin were multiple compared with 23% (11) in those treated conventionally. Of the 17 completed pregnancies in women treated with buserelin, 11 resulted in the birth of live babies (eight singletons, two sets of twins, and one set of triplets) and six failed, five before 12 weeks' gestation and one at 22 weeks. The 13 continuing pregnancies (32 weeks) were eight singletons, two sets of twins, and three sets of triplets. Of the 48 completed pregnancies in women treated with clomiphene citrate, 35 resulted in the birth of live babies (26 singletons, five sets of twins and four sets of triplets) and 13 failed, eleven before 12 weeks' gestation and two by 27 weeks. Buserelin increased the chance of pregnancy after in vitro fertilisation compared with conventional treatment, but the risk of multiple pregnancy may be increased.
将促黄体生成素释放激素激动剂布舍瑞林与人绝经期促性腺激素联合治疗与枸橼酸氯米芬与人绝经期促性腺激素的传统治疗在体外受精结局方面进行了比较。77名不孕妇女接受了83个周期的布舍瑞林与人绝经期促性腺激素联合治疗，同时，另外328名不孕妇女接受了枸橼酸氯米芬与人绝经期促性腺激素治疗。接受布舍瑞林治疗的妇女中有7个周期（8%）因超排卵不足或卵巢过度刺激而取消，接受枸橼酸氯米芬治疗的妇女中有103个周期（31%）因卵泡发育不良而取消。布舍瑞林组回收的卵母细胞平均数量显著更高（9.5（标准差4.5）对5.5（2.2）），获得的胚胎平均数量也更高（4.3（2.4）对2.9（1.7））。接受布舍瑞林治疗后进行胚胎移植的妇女临床妊娠的比例显著更高（53%（30/57）对30%（48/159），即治疗周期的36%对14%）。接受布舍瑞林治疗的妇女中，33%（10例）的妊娠为多胎妊娠，而传统治疗组为23%（11例）。接受布舍瑞林治疗的妇女中有17例完成妊娠，其中11例分娩活婴（8例单胎、2例双胞胎和1例三胞胎），6例妊娠失败，5例在妊娠12周前，1例在22周时。13例持续妊娠（32周）为8例单胎、2例双胞胎和3例三胞胎。接受枸橼酸氯米芬治疗的妇女中有48例完成妊娠，其中35例分娩活婴（26例单胎、5例双胞胎和4例三胞胎），13例妊娠失败，11例在妊娠12周前，2例在27周时。与传统治疗相比，布舍瑞林增加了体外受精后的妊娠机会，但多胎妊娠的风险可能增加。
