促性腺激素释放激素激动剂在控制性卵巢过度刺激过程中对雄烯二酮生成及卵泡发育的影响。
The effects of gonadotropin-releasing hormone agonist on androstenedione production and follicular development during controlled ovarian hyperstimulation.
作者信息
Akaboshi K, Oda T, Yoshida J, Kohriyama S, Miyazaki T, Yoshimura Y
机构信息
Department of Obstetrics and Gynecology, Tokyo Dental College, Chiba, Japan.
出版信息
J Assist Reprod Genet. 1998 Sep;15(8):478-84. doi: 10.1023/a:1022530420110.
PURPOSE
We performed a prospective randomized study to assess the effects of a GnRH agonist (GnRH-a) on follicular development and steroidogenesis during controlled ovarian hyperstimulation (COH).
METHODS
Patients undergoing in vitro fertilization (IVF) for tubal infertility received human menopausal gonadotropin (hMG) stimulation with or without the GnRH-a, buserelin, beginning in the midluteal phase of the prior cycle. We analyzed serum hormone levels, follicular development, and outcome of IVF.
RESULTS
The mean number of retrieved oocytes was significantly greater, and the implantation rate per embryo was significantly higher, in the GnRH-a/hMG group (n = 101) than in the hMG-only group (n = 97). The concentration of androstenedione (A) and the A/estradiol ratio in the serum were significantly lower in the GnRH-a treatment group throughout the follicular phase.
CONCLUSIONS
The concomitant use of GnRH-a during COH prevents atretic change of the follicles and enhances follicular development by reducing androgen accumulation, resulting in a higher developmental competence of the oocytes.
目的
我们进行了一项前瞻性随机研究，以评估促性腺激素释放激素激动剂（GnRH-a）在控制性卵巢过度刺激（COH）期间对卵泡发育和类固醇生成的影响。
方法
因输卵管性不孕接受体外受精（IVF）的患者，从上一周期的黄体中期开始，接受人绝经期促性腺激素（hMG）刺激，同时使用或不使用GnRH-a（布舍瑞林）。我们分析了血清激素水平、卵泡发育情况以及IVF的结果。
结果
GnRH-a/hMG组（n = 101）与仅使用hMG组（n = 97）相比，平均取卵数显著更多，每个胚胎的着床率显著更高。在整个卵泡期，GnRH-a治疗组血清中的雄烯二酮（A）浓度和A/雌二醇比值显著更低。
结论
在COH期间同时使用GnRH-a可防止卵泡闭锁，并通过减少雄激素积累来促进卵泡发育，从而提高卵母细胞的发育能力。
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