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评估生长激素联合治疗在 GnRH 拮抗剂短方案反应更好的患者体外受精中的作用。

Evaluation of growth hormone co-treatment in in vitro fertilization in patients responding better to the GnRH antagonist short protocol.

机构信息

Reproferty (Human Reproduction), São José dos Campos, SP, Brazil.

Christian Life Fundation-FUNVIC, Pindamonhangaba, SP, Brazil.

出版信息

JBRA Assist Reprod. 2020 May 1;24(2):147-151. doi: 10.5935/1518-0557.20190083.

DOI:10.5935/1518-0557.20190083
PMID:32155012
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7169923/
Abstract

OBJECTIVE

The present study aims at evaluating the results obtained after in vitro fertilization in bad responders, using controlled ovarian hyperstimulation together with the use of gonadotrophin releasing hormone (GnRH) antagonist (cetrorelix acetate) in a short protocol.

METHODS

This is an analytical, longitudinal, retrospective and controlled study involving patients who underwent in vitro fertilization (IVF) procedures in the assisted reproduction program of the Reproferty clinic, in the municipality of São José dos Campos/SP, from January 2012 to December 2016. We collected the data obtained from the medical records of patients considered to have undergone controlled ovarian hyperstimulation using GnRH antagonist (cetrorelix acetate) and Growth Hormone (GH) in a short cycle protocol. The patients considered controls were those submitted to the same hyperstimulation process, without using GH.

RESULTS

There were significant differences in the following analyzed parameters: gonadotrophin regimen dose, stimulation duration, and estradiol levels on the day of HCG administration, number of follicles, number of retrieved oocytes, number of mature oocytes and number of good-quality embryos. On the other hand, the GH administration was not significant in the number of cycles that achieved transfer, the number of embryos transferred and the number of frozen cycles. In the case group, there was no increase in the number of cycles that reached pregnancy rate βhCG+; however, the clinical pregnancy rates and live birth rates were significant.

CONCLUSION

The present investigation demonstrated that GH administration as a supplement in poor responders improves the majority of the parameters to achieve a full term pregnancy in these patients.

摘要

目的

本研究旨在评估在体外受精中使用促性腺激素释放激素(GnRH)拮抗剂(醋酸西曲瑞克)进行控制性卵巢超刺激对卵巢反应不良患者的结果。

方法

这是一项分析性、纵向、回顾性和对照研究,涉及 2012 年 1 月至 2016 年 12 月在巴西圣若泽杜斯坎波斯市 Reproferty 诊所辅助生殖计划中接受体外受精(IVF)的患者。我们收集了在 GnRH 拮抗剂(醋酸西曲瑞克)和生长激素(GH)短周期方案中接受控制性卵巢超刺激的患者的病历中获得的数据。对照组患者接受了相同的超刺激过程,但未使用 GH。

结果

在以下分析参数中存在显著差异:促性腺激素方案剂量、刺激持续时间、HCG 给药日的雌二醇水平、卵泡数、获卵数、成熟卵数和优质胚胎数。另一方面,GH 给药在达到转移的周期数、转移的胚胎数和冷冻周期数方面并不显著。在病例组中,达到βhCG+妊娠率的周期数没有增加;然而,临床妊娠率和活产率显著提高。

结论

本研究表明,GH 作为补充剂用于卵巢反应不良患者可改善大多数参数,以实现这些患者的足月妊娠。

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本文引用的文献

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The influence of different growth hormone addition protocols to poor ovarian responders on clinical outcomes in controlled ovary stimulation cycles: A systematic review and meta-analysis.不同生长激素添加方案对卵巢反应不良者在控制性卵巢刺激周期中临床结局的影响:一项系统评价和荟萃分析
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Growth hormone in IVF cycles: any hope?体外受精周期中的生长激素:有希望吗?
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Growth hormone co-treatment within a GnRH agonist long protocol improves implantation and pregnancy rates in patients undergoing IVF-ET.在GnRH激动剂长方案中联合使用生长激素可提高接受体外受精-胚胎移植患者的着床率和妊娠率。
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Does the addition of growth hormone to the in vitro fertilization/intracytoplasmic sperm injection antagonist protocol improve outcomes in poor responders? A randomized, controlled trial.在体外受精/卵胞浆内单精子注射拮抗剂方案中添加生长激素是否能改善低反应者的结局?一项随机对照试验。
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Low-dose growth hormone supplementation increases clinical pregnancy rate in poor responders undergoing in vitro fertilisation.低剂量生长激素补充剂可提高接受体外受精的反应不良者的临床妊娠率。
Gynecol Endocrinol. 2015 Jul;31(7):565-8. doi: 10.3109/09513590.2015.1025378. Epub 2015 Jul 21.
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Adjuvant growth hormone therapy in antagonist protocol in poor responders undergoing assisted reproductive technology.拮抗剂方案中应用生长激素辅助治疗对接受辅助生殖技术的卵巢低反应患者的作用。
Arch Gynecol Obstet. 2013 May;287(5):1017-21. doi: 10.1007/s00404-012-2655-1. Epub 2012 Dec 4.
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The value of growth hormone supplements in ART for poor ovarian responders.生长激素补充剂在卵巢反应不良的 ART 中的价值。
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ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria.ESHRE 共识:体外受精卵巢刺激反应不良的定义:博洛尼亚标准。
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