人绒毛膜促性腺激素诱发排卵的优缺点  

Advantage and disadvantage of hCG trigger

作　　者：马文红[1] 梁晓燕[1] 

机构地区：[1]中山大学附属第六医院生殖医学中心,广州510655

出　　处：《生殖医学杂志》2012年第6期547-550,共4页Journal of Reproductive Medicine

摘　　要：自然月经周期中，随着优势卵泡直径增加，雌二醇（E2）浓度增高，诱发黄体生成素（LH）峰，通过调控卵丘复合物各种基因表达（包括各种炎性因子、细胞因子及蛋白水解酶类及其抑制剂等）引起卵母细胞减数分裂的恢复、排卵及黄体形成。在辅助生殖的控制性卵巢刺激（COS）周期中，使用GnRH激动剂（GnRH—a）或拮抗剂（GnRH-ant）防止内源性早发LH峰以控制精确的取卵时间，后使用外源性药物达到与内源性LH峰相同的作用。The midcyele surge of luteinizing hormone （LH） is absolutely required for final maturation of the oocyte, initiation of follicular rupture and corpus luteum function. Human chorionic gonadotrophin （hCG） or GnRH analogue （GnRH-a） is used for final oocyte maturation in assisted conception cycles. Which one is used usually depends on controlled ovarian stimulation （COS） protocol with different hypothalamus-pituitary condition, hCG trigger induces better luteum function, pregnancy rate, but higher ovarian hyperstimulation syndrome （OHSS）. GnRH-a causes lower OHSS with impaired pregnant and miscarriage rate, which could be improved by intensity luteum supply. We do not recommend that GnRH agonists are routinely used as a final oocyte maturation trigger in fresh autologous cycles because of lowered ongoing pregnancy and live birth rates. An exception could high risk of OHSS.

关 键 词：辅助生殖 黄体生成素峰 人绒毛膜促性腺激素 促性腺激素释放激素类似物 卵巢过度刺激综合征 

分 类 号：R3[医药卫生—基础医学]