不同拮抗剂在促性腺激素释放激素拮抗剂方案中的应用  

Effects of Different Antagonists in Gonadotropin Releasing Hormone Antagonist Cycles

作　　者：夏婷婷[1] 万子晴 陶林林 林晓琪 欧建平[1] XIA Ting-ting;WAN Zi-qing;TAO Lin-lin;LIN Xiao-qi;OU Jian-ping(Center for Reproductive Medicine,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院生殖医学中心,广东广州510630

出　　处：《中山大学学报（医学科学版）》2022年第4期645-652,共8页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省医学科研基金(A2020575)。

摘　　要：【目的】研究促性腺激素释放激素拮抗剂(GnRH-ant)方案中应用加尼瑞克1、加尼瑞克2与西曲瑞克抑制内源性黄体生成素(LH)峰的差异及对临床妊娠结局的影响。【方法】回顾性分析中山大学附属第三医院生殖医学中心2019年10月-2020年12月应用GnRH-ant方案行体外受精/卵胞质内单精子注射(IVF/ICSI)助孕患者共1434个周期,根据使用拮抗剂药物不同分为3组。1组:加尼瑞克1组(461周期),2组:加尼瑞克2组(741周期),3组:西曲瑞克组(232周期),分析比较3组患者基本资料、促排卵过程及临床妊娠结局。【结果】3组患者年龄、体质量指数、抗缪勒管激素等一般资料无差异;3组患者获卵数、扳机日LH>10 U/L所占比例、中重度卵巢过度刺激综合征(OHSS)发生率、成熟卵子数、新鲜胚胎移植临床妊娠率及活产率差异均无统计学意义(P>0.05)。加尼瑞克1组早期流产率显著高于加尼瑞克2组(21.5%vs.9.7%,P<0.05)。【结论】3种拮抗剂在GnRH-ant方案中扳机日早发LH峰发生率、中重度OHSS发生率、临床妊娠率及活产率相似,但新鲜移植周期加尼瑞克1组早期流产率升高,其不良妊娠结局风险可能增加。【Objective】To compare the effects of ganirelix1,ganirelix2 and cetrorelix for preventing premature lutein⁃izing hormone(LH)surges and on clinical outcomes in gonadotropin-releasing hormone antagonist(GnRH-ant)cycles.【Methods】We retrospectively analyzed 1434 GnRH-ant cycles of in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)at the Reproductive Medical Center of The Third Affiliated Hospital of Sun Yat-sen University from October,2019 to December,2020,including 461 cycles with ganirelix 1 treatment(Group 1),741 cycles with ganirelix 2 treat⁃ment(Group 2)and 232 cycles with cetrorelix treatment(Group 3).The baseline characteristics of the patients and the clinical outcomes of the three groups were compared【.Results】There were no significantly differences found in age,body mass index and anti-Müllerian hormone among the three groups.There were no significant differences in number of oo⁃cytes,proportion of LH>10 U/L on human chorionic gonadotrophin(hCG)trigger day,incidence of moderate/severe ovar⁃ian hyperstimulation syndrome(OHSS),mature oocytes,clinical pregnancy rate and live birth rate following fresh embryo transfer among the three groups(P>0.05).The early pregnancy loss rate of ganirelix 1 group was significantly higher than that of ganirelix 2 group(P<0.05)【.Conclusion】There were similar incidence of premature LH surge in hCG day,moder⁃ate/severe OHSS,clinical pregnancy rate and live birth rate in GnRH-ant protocols among the three antagonists.The gani⁃relix 1 group may have a higher risk of adverse pregnancy outcome following fresh transfer since the high early pregnancy loss rate of it.

关 键 词：拮抗剂方案 加尼瑞克 西曲瑞克 

分 类 号：R711.6[医药卫生—妇产科学]