Gonen Y, Dirnfeld M, Abramovici H
Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center, Haifa, Israel.
J Assist Reprod Genet. 1993 Aug;10(6):437-9. doi: 10.1007/BF01228095.
In recent years the down-regulation of pituitary function by GnRH-a, before and during ovarian stimulation for IVF, has been widely used. When GnRH-a are commenced in the luteal phase, it is inevitable that some early human embryos will be exposed. To the best of our knowledge the total number of reported deliveries following exposure is less than 30. We report here a further nine uneventful pregnancies with successful neonatal outcomes and three early miscarriages. It is our belief that the favorable outcome in patients presented here, who inadvertently received GnRH-a in early unsuspected gestation, is related to the use of short-acting analogues (Buserelin nasal spray). This enabled immediate discontinuation of the drug when the presence of pregnancy was suspected. In addition, the routine administration of progesterone supplements is strongly recommended, regardless of the hormonal levels.
近年来，在体外受精（IVF）的卵巢刺激之前及期间，使用促性腺激素释放激素激动剂（GnRH-a）下调垂体功能已被广泛应用。当在黄体期开始使用GnRH-a时，一些早期人类胚胎不可避免地会受到影响。据我们所知，暴露后报告的分娩总数少于30例。我们在此报告另外9例顺利妊娠并成功分娩新生儿，以及3例早期流产。我们认为，此处报告的患者在早期未被怀疑妊娠时无意中接受了GnRH-a，但仍获得良好结局，这与使用短效类似物（布舍瑞林鼻喷雾剂）有关。当怀疑妊娠时，这使得能够立即停用该药物。此外，无论激素水平如何，强烈建议常规补充孕激素。
