拮抗剂方案中出现早发性黄体生成素峰的处理——病案报道3例  

The treatment of premature luteinizing hormone rise in the gonadotrophin-releasing hormone antagonist protocol——3 cases report

作　　者：农璎琦[1] 阮建兴[1] 陈烨[1] 刘文娟 陈兰媚[1] 刘风华[1] Nong Yingqi;Ruan Jianxing;Chen Ye;Liu Wenjuan;Chert Lanmei;Liu Fenghua(Guangdong Women and Children Hospital, Guangzhou 510010, China)

机构地区：[1]广东省妇幼保健院生殖健康与不孕症科,广州510010

出　　处：《中华生殖与避孕杂志》2018年第3期244-247,共4页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨拮抗剂方案促排卵过程中出现早发黄体生成素(LH)峰的患者实施紧急取卵是否有效。方法 3例患者均采用拮抗剂促排卵方案,促排卵过程中密切监测卵泡发育情况及血激素水平变化,当卵泡期监测到早发性LH峰或扳机次日雌激素水平快速下降时,根据具体情况安排提前取卵。结果 3例患者均能取到成熟卵子,并获得优质胚胎。结论拮抗剂方案也可能出现"LH逃逸"现象,需在促排卵过程中密切监测血清LH水平,当出现早发性LH峰时,"抢收"可增加体外受精-胚胎移植(IVF-ET)的获卵率,不失为一种有效的处理措施。Objective To determine whether emergency oocyte retrieval strategy （rush in the harves） is effective when a premature rise in the level of luteinizing hormone （LH） in gonadotrophin-releasing hormone antagonists （GnRH-A） protocol in vitro fertilization （IVF） cycles. Methods Three cases were undertaken GnRH-A protocol for ovarian stimulation protocol, during the the process of ovarian stimulation, the development of follicles and the changes of blood hormone levels were monitored closely, when premature LH rising during the follicular phase and estrogen levels decreasing were found in the next day ofhCG injection, emergency oocyte retrieval strategy was carried out. Result Mature eggs and high-quality embryos were obtained from 3 patients. Conclusion Premature LH rise is also present in GnRH-A protocol, when the prematttre LH peak is monitored, ＂rush in the harvest＂ can increase the oocytes retrieved rate of IVF-embryo transfer （ET）, so it is an effective treatment measure.

关 键 词：早发性黄体生成素(LH)峰 拮抗剂方案 提前取卵 

分 类 号：R714.8[医药卫生—妇产科学]