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在卵母细胞捐赠者/接受者计划中,单纯使用促卵泡激素(FSH)与FSH联合促性腺激素释放激素(GnRH)拮抗剂进行卵巢刺激用于选择性冷冻:一项多中心试点观察性研究方案

Ovarian Stimulation with FSH Alone versus FSH plus a GnRH Antagonist for Elective Freezing in an Oocyte Donor/Recipient Programme: A Protocol for a Pilot Multicenter Observational Study.

作者信息

Messinis Ioannis E, Messini Christina I, Papanikolaou Evangelos G, Makrakis Evangelos, Loutradis Dimitrios, Christoforidis Nikolaos, Arkoulis Theodosis, Anifandis Georgios, Daponte Alexandros, Siristatidis Charalampos

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 415 00 Larissa, Greece.

Assisting Nature IVF Unit, Giannou Kranidiotis, & Avenue 2, 570 01 Thessaloniki, Greece.

出版信息

J Clin Med. 2023 Apr 6;12(7):2743. doi: 10.3390/jcm12072743.

Abstract

Preliminary data have shown that it is possible to attempt in vitro fertilization (IVF) treatment in fresh cycles without the use of a gonadotropin-releasing hormone (GnRH) antagonist or any other medication to prevent the luteinizing hormone (LH) surge during ovarian stimulation. To date, there is no information on this topic in the context of a prospective controlled trial. However, as prevention of the LH surge is an established procedure in fresh cycles, the question is whether such a study can be performed in frozen cycles. We aim to perform a pilot study in order to compare the efficacy of a protocol using FSH alone with that of a protocol using follicle-stimulating hormone (FSH) plus a GnRH antagonist for controlled ovarian hyperstimulation (COH) in cycles of elective freezing in the context of a donor/recipient program. This is a seven-center, two-arm prospective pilot cohort study conducted at the respective Assisted Reproductive Units in Greece. The hypothesis to be tested is that an ovarian stimulation protocol that includes FSH alone without any LH surge prevention regimens is not inferior to a protocol including FSH plus a GnRH antagonist in terms of the clinical outcome in a donor/recipient model. The results of the present study are expected to show whether the addition of the GnRH antagonist is necessary in terms of the frequency of LH secretory peaks and progesterone elevations >1 ng/mL during the administration of the GnRH antagonist according to the adopted frequency of blood sampling in all Units.

摘要

初步数据表明,在新鲜周期中尝试体外受精(IVF)治疗时,不使用促性腺激素释放激素(GnRH)拮抗剂或任何其他药物来预防卵巢刺激期间的促黄体生成素(LH)激增是可行的。迄今为止,在前瞻性对照试验的背景下,尚无关于该主题的信息。然而,由于预防LH激增是新鲜周期中的既定程序,问题在于这样的研究能否在冷冻周期中进行。我们旨在进行一项试点研究,以比较在供体/受体计划背景下,单独使用促卵泡激素(FSH)的方案与使用促卵泡激素(FSH)加GnRH拮抗剂的方案在选择性冷冻周期中进行控制性卵巢过度刺激(COH)的疗效。这是一项在希腊各辅助生殖单位进行的七中心、双臂前瞻性试点队列研究。有待检验的假设是,在供体/受体模型中,不包括任何LH激增预防方案、仅包含FSH的卵巢刺激方案在临床结局方面不劣于包含FSH加GnRH拮抗剂的方案。根据所有单位采用的采血频率,本研究结果有望表明,就GnRH拮抗剂给药期间LH分泌峰值频率和孕酮升高>1 ng/mL而言,添加GnRH拮抗剂是否必要。

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