在体外受精中，垂体抑制后单独使用纯的和高纯度促卵泡激素，或与人类绝经期促性腺激素联合用于卵巢刺激。

Pure and highly purified follicle-stimulating hormone alone or in combination with human menopausal gonadotrophin for ovarian stimulation after pituitary suppression in in-vitro fertilization.

作者信息

Balasch J, Fábregues F, Creus M, Moreno V, Puerto B, Peñarrubia J, Carmona F, Vanrell J A

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Barcelona, Hospital Clínic i Provincial, Spain.

出版信息

Hum Reprod. 1996 Nov;11(11):2400-4. doi: 10.1093/oxfordjournals.humrep.a019123.

DOI:10.1093/oxfordjournals.humrep.a019123

PMID:8981119

Abstract

The use of pure follicle stimulating hormone (pFSH) and highly purified FSH (FSH-HP) versus the combinations pFSH/human menopausal gonadotrophin (HMG) and FSH HP/HMG, respectively, was compared for stimulating follicular development after gonadotrophin-releasing hormone agonist (GnRHa) suppression in women undergoing in vitro fertilization (IVF)-embryo transfer. Two consecutive prospective, randomized studies were carried out at the Assisted Reproduction Unit of the Hospital Clínic i Provincial in Barcelona, a tertiary care setting. Two groups of 188 (study 1) and 252 (study 2) consecutive infertile patients respectively, scheduled for IVF-embryo transfer were included. Pretreatment with leuprolide acetate (long protocol) was followed by gonadotrophin treatment in all patients. In study 1, 92 patients received i.m. pFSH alone (group pFSH) and 96 were treated with the combination of i.m. pFSH and i.m. HMG (group HMG-1). In study 2, 123 patients received s.c. FSH-HP alone (group FSH-HP) and 129 patients were given the combination of s.c. FSH-HP and i.m. HMG (group HMG-2). Main outcome measures included follicular development, oocyte retrieval, fertilized oocytes, duration and dose of gonadotrophin therapy, and clinical pregnancy. There were no significant differences between pFSH and pFSH/HMG nor between FSH-HP and FSH-HP/HMG cycles with regard to the number of ampoules of medication used, day of human chorionic gonadotrophin (HCG) administration, mean peak serum oestradiol concentrations, number of follicles punctured, and number of oocytes aspirated, embryos transferred, or pregnancies. We conclude that urinary FSH (either purified of highly purified) alone is as effective as the conventional combination of urinary FSH/HMG for ovarian stimulation under pituitary suppression in IVF cycles. Therefore, they can be used interchangeably in IVF programmes.

摘要

在接受体外受精（IVF）-胚胎移植的女性中，比较了使用纯卵泡刺激素（pFSH）和高纯度FSH（FSH-HP）分别与pFSH/人绝经期促性腺激素（HMG）及FSH-HP/HMG组合在促性腺激素释放激素激动剂（GnRHa）抑制后刺激卵泡发育的效果。在巴塞罗那省医院临床辅助生殖科这一三级医疗机构进行了两项连续的前瞻性随机研究。分别纳入了两组连续的计划进行IVF-胚胎移植的不孕患者，研究1组有188例，研究2组有252例。所有患者均先接受醋酸亮丙瑞林预处理（长方案），随后进行促性腺激素治疗。在研究1中，92例患者单独接受肌肉注射pFSH（pFSH组），96例患者接受肌肉注射pFSH与肌肉注射HMG的联合治疗（HMG-1组）。在研究2中，123例患者单独接受皮下注射FSH-HP（FSH-HP组），129例患者接受皮下注射FSH-HP与肌肉注射HMG的联合治疗（HMG-2组）。主要观察指标包括卵泡发育、取卵、受精的卵母细胞、促性腺激素治疗的持续时间和剂量以及临床妊娠情况。在使用药物安瓿数量、人绒毛膜促性腺激素（HCG）给药日、血清雌二醇平均峰值浓度、穿刺卵泡数量、吸出的卵母细胞数量、移植胚胎数量或妊娠情况方面，pFSH组与pFSH/HMG组之间以及FSH-HP组与FSH-HP/HMG组之间均无显著差异。我们得出结论，在IVF周期中垂体抑制状态下，单独使用尿促卵泡素（无论是纯化的还是高度纯化的）与尿促卵泡素/人绝经期促性腺激素的传统组合在刺激卵巢方面效果相同。因此，它们在IVF方案中可互换使用。