GnRH激动剂长方案和GnRH拮抗剂方案对IVF-ET结局的影响:一项前瞻性随机对照研究  

Comparison of controlled ovarian stimulation response and IVF-ET outcome between GnRH antagonist protocol and GnRH agonist long protocol:A prospective randomized study

作　　者：陈华[1] 彭献东[1] 韩金兰[1] 余敏[1] 刘素英[1] 孙晓溪[1] 

机构地区：[1]上海集爱遗传与不育诊疗中心,上海市200011

出　　处：《生殖医学杂志》2013年第1期8-13,共6页Journal of Reproductive Medicine

摘　　要：控制性超排卵（COH）是体外受精一胚胎移植（IVF_ET）技术的重要组成部分，1984年Porter和Craft首先将人工合成的促性腺激素释放激素激动剂（gonadotropinreleasinghormoneagonist，GnRH—a）用在IVF中的促排卵治疗[1]，有效地扼制了早发黄体生成素（LH）峰，降低了周期取消率，保证了IVF-ETl的成功率。Objective. GnRH antagonist（GnRH-ant）protocol is being widely accepted in IVF-ET because of the safety and convenience. However,the outcome of IVF-ET is still complicated in previous reports. The aim of this study was to compare the differences of IVF-ET outcome between GnRH-ant and GnRH agonist （GnRH-a） protocol. Methods. Sixty-four eligible undergoing IVF/ICSI patients were collected for this prospective randomized controlled trial.GnRH-ant group with 0.25mg ganirelix（n= 32）and long GnRH-a group with Results： Compare with long GnRH-a group, GnRH-ant group showed lower total amount of gonadotropin required [-（ 1476.61 ~ 260. 11 ） vs. （1713.28 ± 368.46 ） IU, P〈 0.01], shorter stimulation duration [- （9. 59 d： 1.29） vs. （ 10.91 ± 1.23） days, （P 〈 0. 001 ） ], and lower estradiol levels on HCG day [-（8,646. 64±3,714. 57）vs. （12,013.84±5,393. 6？）pmol/L, （P〈0. 001）]. No differences were observed in two groups in average of top-quality embryo,implantation rate（30.7 % vs. 31.5 %）, clinical pregnancy rate （48% vs. 48%）and live birth rate（41% vs. 44.4 %）. Further more,the two groups showed a similar accumulative pregnancy（70% vs. 63%）and live birth rate（63.3% vs. 60%）in the subsequent frozen embryo transfer（FET） cycles. Conclusions： GnRH-ant protocol might be an alternative choice for controlled ovarian hyperstimulation in IVF-ET.

关 键 词：GNRH激动剂 GNRH拮抗剂 超促排卵 体外受精一胚胎移植 临床妊娠率 累积妊娠率 

分 类 号：R[医药卫生]