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一项比较促卵泡激素(FSH)与人绝经期促性腺激素(hMG)在体外受精中作用的随机对照试验

[A randomized, controlled trial comparing follicle stimulating hormone (FSH) to human menopausal gonadotropin (hMG) in fertilization in vitro].

作者信息

Daya S, Gumby J, Hughes E G, Collins J A, Sagle M A

机构信息

Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.

出版信息

Contracept Fertil Sex. 1995 Dec;23(12):766-71.

PMID:8556078
Abstract

The adverse effect of raised luteinizing hormone (LH) concentrations on reproductive outcome suggests that exogenous LH administration for ovarian stimulation may not be desirable. The aim of this study was to compare the clinical pregnancy rates between follicle stimulating hormone (FSH) and human menopausal gonadotrophin (HMG) used in in-vitro fertilization (IVF) cycles. A total of 232 infertile patients, with a mean duration of infertility of 67.1 +/- 32.9 months, were selected for IVF (female age < 38 years, FSH < 15 IU/l, and total motile sperm count > 5 x 10(6). A short (flare-up) protocol with daily leuprolide acetate was followed randomly from day 3 with FSH (n = 115) or human menopausal gonadotrophin (HMG; n = 117), at an initial dose of two ampoules per day. A maximum of three embryos was transferred, and the luteal phase was supported with four doses of HCG (2,500 IU). No differences were observed between the two groups in any of the cycle response variables except fertilization rates per oocyte and per patient, both of which were significantly higher with FSH. Clinical pregnancy rates per cycle initiated, per oocyte retrieval and per embryo transfer were 19.1, 21.0 and 22.7% respectively for FSH, and 12.0, 12.8 and 15.4% respectively for HMG. Whilst these differences were not statistically significant, the results of this interim analysis suggest that HMG may be associated with a lower clinical pregnancy rate than FSH.

摘要

促黄体生成素(LH)浓度升高对生殖结局的不良影响表明,用于卵巢刺激的外源性LH给药可能并不理想。本研究的目的是比较体外受精(IVF)周期中使用卵泡刺激素(FSH)和人绝经期促性腺激素(HMG)后的临床妊娠率。总共232例不孕患者被选入IVF,其平均不孕时间为67.1±32.9个月(女性年龄<38岁,FSH<15 IU/l,总活动精子计数>5×10⁶)。从第3天开始随机采用每日醋酸亮丙瑞林的短方案(激发方案),分别使用FSH(n = 115)或人绝经期促性腺激素(HMG;n = 117),初始剂量为每日两支安瓿。最多移植3个胚胎,黄体期用4剂HCG(2500 IU)支持。除了每个卵母细胞和每个患者的受精率外,两组在任何周期反应变量上均未观察到差异,而这两个受精率在FSH组均显著更高。FSH组每个启动周期、每个取卵周期和每个胚胎移植周期的临床妊娠率分别为19.1%、21.0%和22.7%,HMG组分别为12.0%、12.8%和15.4%。虽然这些差异无统计学意义,但这项中期分析的结果表明,HMG可能比FSH的临床妊娠率更低。

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