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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.

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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