Testart J, Lefevre B, Gougeon A
INSERM Unité 355-32, Clamart, France.
Hum Reprod. 1993 Apr;8(4):511-8. doi: 10.1093/oxfordjournals.humrep.a138086.
This review summarizes the main clinical and research studies on direct and indirect effects of gonadotrophin-releasing hormone agonists (GnRHa) on follicles and oocytes in animals and humans. There is evidence for extra-pituitary actions of GnRHa, especially on follicle growth, follicular steroidogenesis, and oocyte meiotic maturation. Different effects have been reported from using various GnRHa molecules. However, a direct effect of GnRHa on oocyte quality in gonadotrophin stimulated cycles has not yet been demonstrated. Observed high pregnancy rates per ovarian puncture in in-vitro fertilization cycles using GnRHa, at least in long protocols, might result from higher numbers of oocytes recovered following administration of large doses of gonadotrophins, despite the fact that these oocytes may have a lower ability to fertilize and grow. Although there are obvious clinical advantages of using GnRHa for ovarian stimulation, more studies are needed to clarify the effects of these treatments at ovarian and uterine levels.
本综述总结了关于促性腺激素释放激素激动剂（GnRHa）对动物和人类卵泡及卵母细胞的直接和间接影响的主要临床及研究。有证据表明GnRHa存在垂体外作用，尤其是对卵泡生长、卵泡类固醇生成及卵母细胞减数分裂成熟的作用。使用不同的GnRHa分子报道了不同的效果。然而，GnRHa对促性腺激素刺激周期中卵母细胞质量的直接影响尚未得到证实。在使用GnRHa的体外受精周期中，观察到的每次卵巢穿刺的高妊娠率，至少在长方案中，可能是由于大剂量促性腺激素给药后回收的卵母细胞数量增加，尽管这些卵母细胞的受精和生长能力可能较低。尽管使用GnRHa进行卵巢刺激有明显的临床优势，但仍需要更多研究来阐明这些治疗在卵巢和子宫水平的影响。
