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新型口服促性腺激素释放激素受体拮抗剂relugolix是控制性卵巢刺激周期的一种新选择。

The novel oral gonadotropin-releasing hormone receptor antagonist relugolix is a new option for controlled ovarian stimulation cycles.

作者信息

Komiya Shinnosuke, Tsuzuki-Nakao Tomoko, Asai Yoshiko, Inoue Tomoko, Morimoto Yoshiharu, Okada Hidetaka

机构信息

Department of Obstetrics and Gynecology Kansai Medical University Graduate School of Medicine Osaka Japan.

HORAC Grand Front Osaka Clinic Osaka Japan.

出版信息

Reprod Med Biol. 2022 Feb 17;21(1):e12448. doi: 10.1002/rmb2.12448. eCollection 2022 Jan-Dec.

Abstract

PURPOSE

Relugolix is an oral gonadotropin-releasing hormone antagonist (GnRHant), which was first introduced in 2019. This study investigated the effects of the conventional injectable GnRHant formulation and this new oral GnRHant formulation on controlled ovarian stimulation (COS) cycles.

METHODS

Relugolix was administered in 126 cycles and conventional GnRHant injection was administered in 658 cycles (controls). The follicle stimulation was performed by an antagonist method, and for final oocyte maturation, recombinant human chorionic gonadotropin (rHCG), or gonadotropin-releasing hormone agonist (GnRHa), or both (dual trigger) were selected. The number of retrieved oocytes was counted and then they were evaluated for subsequent development up to cleavage stage.

RESULTS

The number of retrieved oocytes which was the primary outcome of this research was affected by the combination of GnRHant type and the final oocyte maturation agent. The combination of relugolix and a GnRHa trigger showed a significantly lower number of retrieved oocytes ( < 0.001) than the other combinations.

CONCLUSIONS

Relugolix is a new option for COS cycles, but should be carefully combined with the final maturation agent.

CLINICAL TRIAL APPROVAL

This study was conducted after approval by the Medical Corporation Sankeikai Institutional Ethics Committee (approval number: 2019-34).

摘要

目的

relugolix是一种口服促性腺激素释放激素拮抗剂(GnRHant),于2019年首次推出。本研究调查了传统的注射用GnRHant制剂和这种新型口服GnRHant制剂对控制性卵巢刺激(COS)周期的影响。

方法

126个周期使用relugolix,658个周期使用传统GnRHant注射剂(对照组)。采用拮抗剂法进行卵泡刺激,对于最终的卵母细胞成熟,选择重组人绒毛膜促性腺激素(rHCG)、促性腺激素释放激素激动剂(GnRHa)或两者联合使用(双重触发)。对回收的卵母细胞进行计数,然后评估其后续发育至分裂期的情况。

结果

作为本研究主要结果的回收卵母细胞数量受GnRHant类型和最终卵母细胞成熟剂组合的影响。relugolix与GnRHa触发剂联合使用时,回收的卵母细胞数量显著低于其他组合(<0.001)。

结论

relugolix是COS周期的一种新选择,但应谨慎与最终成熟剂联合使用。

临床试验批准

本研究在获三启会医疗法人社团机构伦理委员会批准后进行(批准号:2019-34)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ce/8967300/7191eff9f270/RMB2-21-e12448-g001.jpg

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