Zanetti Bianca Ferrarini, Braga Daniela Paes de Almeida Ferreira, Setti Amanda Souza, Iaconelli Assumpto, Borges Edson
Fertility Medical Group, São Paulo, SP - Brazil.
Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil.
JBRA Assist Reprod. 2020 Jan 30;24(1):24-29. doi: 10.5935/1518-0557.20190050.
To compare the effect of pituitary suppression regimens on oocyte morphology in consecutive ICSI cycles of the same patients.
Data was obtained from 200 matched consecutive intracytoplasmic sperm injection (ICSI) cycles performed in 100 couples undergoing the first cycle with the GnRH agonist and the following cycle with the GnRH antagonist regimen, from January 2010 to August 2016, in a private university-affiliated IVF centre. The effects of the pituitary suppression type on oocyte morphology were assessed by multivariate General Linear Models.
Mean interval between cycles was 185.32±192.85 days. Maternal age, body mass index, and total FSH dose administered were similar in both patients' cycles. Antagonist cycles presented lower incidence of dark cytoplasm (0.69±3.28% vs. 4.40±17.70%, p=0.047), Smooth endoplasmic reticulum (SER cluster (4.37±11.62% vs. 7.36±17.17%, p=0.046), and ZP defects (6.05±14.76% vs. 11.84±25.13%, p=0.049). Similar numbers of follicles retrieved oocytes, and mature oocytes were observed between the GnRH groups, as well as the fertilisation rate, number of obtained embryos, high-quality embryo rates, and the clinical outcomes.
GnRH antagonist's inhibitory effect on the ovaries in consecutive ICSI cycles results in improved oocyte maturity and morphology, despite similar laboratory and clinical outcomes, compared to the GnRH agonist treatment.
比较垂体抑制方案对同一患者连续进行的卵胞浆内单精子注射（ICSI）周期中卵母细胞形态的影响。
数据来自2010年1月至2016年8月在一家私立大学附属体外受精中心对100对夫妇进行的200个匹配的连续卵胞浆内单精子注射（ICSI）周期。第一周期使用促性腺激素释放激素（GnRH）激动剂，随后周期使用GnRH拮抗剂方案。通过多变量一般线性模型评估垂体抑制类型对卵母细胞形态的影响。
两个周期之间的平均间隔为185.32±192.85天。两个患者周期中的产妇年龄、体重指数和总促卵泡激素（FSH）剂量相似。拮抗剂周期中暗细胞质的发生率较低（0.69±3.28%对4.40±17.70%，p = 0.047），滑面内质网（SER）聚集（4.37±11.62%对7.36±17.17%，p = 0.046），以及透明带（ZP）缺陷（6.05±14.76%对11.84±25.13%，p = 0.049）。在GnRH组之间观察到回收的卵泡、卵母细胞和成熟卵母细胞数量相似，以及受精率、获得的胚胎数量、优质胚胎率和临床结局。
与GnRH激动剂治疗相比，在连续的ICSI周期中，GnRH拮抗剂对卵巢的抑制作用导致卵母细胞成熟度和形态得到改善，尽管实验室和临床结局相似。
