Porcu E, Dal Prato L, Seracchioli R, Fabbri R, Longhi M, Flamigni C
Department of Reproductive Physiology and Pathology, University of Bologna, Italy.
Fertil Steril. 1994 Jul;62(1):126-32. doi: 10.1016/s0015-0282(16)56827-7.
To compare the effects of depot and standard release form of triptoreline in superovulation induction in IVF programs.
One hundred ninety-six patients undergoing IVF were randomized between two treatment groups. Pituitary desensitization was obtained in group 1 (102 patients) with a single IM injection of 3.75 mg D-Trp-6-luteinizing hormone-releasing hormone (LH-RH) and, in group 2 (94 patients), with daily SC administration of 0.1 mg D-Trp-6-LH-RH. In a subgroup of 11 patients, a series of GnRH tests was performed to investigate pituitary desensitization and, in another subgroup of 12 patients, a study of luteal phase steroid profile was performed. In an additional 23 patients, a series of GnRH tests were performed to investigate pituitary desensitization during the late follicular and midluteal phases.
No differences were found in the time necessary to reach desensitization (11.3 +/- 1.03 versus 11.3 +/- 1.45 days; mean +/- SEM), whereas resumption of pituitary activity takes place in 7 days after the discontinuation of the daily form and in about 2 months after discontinuation of the depot form. No differences were found in the duration of stimulation, number of FSH ampules, E2 levels, and number of follicles (11.7 +/- 0.68, versus 12.2 +/- 0.68) on hCG administration day and the total oocytes collected (9.1 +/- 0.6 versus 9.2 +/- 0.64). Oocyte quality, percentage of fertilization and cleavage, pregnancy rate per transfer (28.7% versus 25.6%), and miscarriages (about 30%) were similar in the two protocols. No difference was found in hormonal levels during the luteal phase. In both groups there was a high incidence of multiple pregnancy.
Comparable results can be achieved with both long-acting and standard-release forms of GnRH analogs in patients undergoing assisted reproduction in terms of follicular stimulation and abortion rates despite differences in the duration of pituitary suppression.
比较长效和标准释放剂型曲普瑞林在体外受精（IVF）程序中诱导超排卵的效果。
196例接受IVF的患者被随机分为两个治疗组。第1组（102例患者）单次肌内注射3.75mg D-色氨酸-6-促黄体生成素释放激素（LH-RH）实现垂体脱敏，第2组（94例患者）每日皮下注射0.1mg D-色氨酸-6-LH-RH实现垂体脱敏。在11例患者的亚组中，进行了一系列促性腺激素释放激素（GnRH）试验以研究垂体脱敏情况，在另一组12例患者中，进行了黄体期甾体激素谱研究。另外23例患者进行了一系列GnRH试验，以研究卵泡晚期和黄体中期的垂体脱敏情况。
在达到脱敏所需时间上未发现差异（11.3±1.03天对11.3±1.45天；均值±标准误），而垂体活性在每日剂型停药后7天恢复，在长效剂型停药后约2个月恢复。在给予人绒毛膜促性腺激素（hCG）当天，刺激持续时间、促卵泡生成素（FSH）安瓿数量、雌二醇（E2）水平、卵泡数量（11.7±0.68对12.2±0.68）以及收集的总卵母细胞数量（9.1±0.6对9.2±0.64）均未发现差异。两种方案的卵母细胞质量、受精和分裂百分比、每次移植的妊娠率（28.7%对25.6%）以及流产率（约30%）相似。黄体期激素水平未发现差异。两组多胎妊娠发生率均较高。
尽管垂体抑制持续时间存在差异，但在接受辅助生殖的患者中，长效和标准释放剂型的GnRH类似物在卵泡刺激和流产率方面可取得相当的结果。
