体外受精程序中的长效促性腺激素释放激素激动剂方案。它适用于促卵泡生成素水平正常但促卵泡生成素/促黄体生成素比值较高的女性吗？

Long GnRH-agonist protocol in an IVF program. Is it appropriate for women with normal FSH levels and high FSH/LH ratios?

作者信息

Yang J H, Wu M Y, Chao K H, Chen S U, Ho H N, Yang Y S

机构信息

Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, R.O.C.

出版信息

J Reprod Med. 1997 Oct;42(10):663-8.

PMID:9350023

Abstract

OBJECTIVE

To determine whether subjects with an elevated ratio of follicle-stimulating hormone (FSH) to luteinizing hormone (LH) but normal basal FSH levels should be regarded as poor responders to controlled ovarian hyperstimulation.

STUDY DESIGN

One hundred twenty-five women undergoing in vitro fertilization (IVF) for the first time were recruited in this retrospective cohort study. Women over 40 years old or having serum basal FSH > 10 mIU/mL were excluded.

RESULTS

Various cutoff values for the FSH/LH ratio were chosen, and the ratio demonstrated that pregnancy rates were apparently higher in patients with the long protocol than with the short one if they had an FSH/LH ratio < 3.0 (48.5% vs. 25.8%, P = .034), < 2.5 (53.3% vs. 28.6%, P = .030) or < 2.0 (57.8% vs. 21.7%, P = .005). Pregnancy rates were similar with the long and short protocols in patients with FSH/LH > or = 3.0 (57.1% vs. 70%, P = .521), FSH/LH > or = 2.5 (40% vs. 53.8%, P = .435) or FSH/LH > or = 2.0 (40% vs. 55.6%, P = .281).

CONCLUSION

This study failed to demonstrate that FSH/LH was a useful parameter for predicting reproductive outcome in IVF programs and for patient selection for the long or short gonadotropin-releasing hormone agonist protocol.

摘要

目的

确定促卵泡激素（FSH）与促黄体生成素（LH）比值升高但基础FSH水平正常的受试者是否应被视为控制性卵巢刺激反应不良者。

研究设计

在这项回顾性队列研究中招募了125名首次接受体外受精（IVF）的女性。排除40岁以上或血清基础FSH>10 mIU/mL的女性。

结果

选择了FSH/LH比值的各种临界值，该比值表明，采用长方案且FSH/LH比值<3.0（48.5%对25.8%，P = 0.034）、<2.5（53.3%对28.6%，P = 0.030）或<2.0（57.8%对21.7%，P = 0.005）的患者，其妊娠率明显高于采用短方案的患者。FSH/LH≥3.0（57.1%对70%，P = 0.521）、FSH/LH≥2.5（40%对53.8%，P = 0.435）或FSH/LH≥2.0（40%对55.6%，P = 0.281）的患者，长方案和短方案的妊娠率相似。