GnRH拮抗剂在体外受精-胚胎移植中的应用

The use of regimen of Gonadotropin-Releasing Hormone antagonist in patients who underwent in vitro fertilization

目的探讨促性腺激素释放激素(GnRH)拮抗剂方案在体外受精-胚胎移植(IVF-ET)促超排卵中的应用效果。方法回顾性比较分析本中心2006年8月～2007年8月接受IVF-ET助孕治疗的患者中采用GnRH拮抗剂方案的54例患者和采用GnRH激动剂长方案的135例患者,观察其临床效果。结果两组Gn用量、HCG日内膜厚度、受精率、卵裂率之间比较无显著性差异;两组患者Gn使用天数、HCG日E2值、获卵数、冷冻率、种植率、妊娠率、OHSS发生率之间比较有显著性差异。结论GnRH拮抗剂联合促性腺激素促超排卵方案缩短用药时间,减少费用,并可显著降低OHSS的发生率,但冷冻率、妊娠率较GnRH激动剂长方案偏低。

Objective ： To evaluate the efficacy of the gonadotropin - releasing hormone antagonist protocol and the gonadotropin - releasing hormone agunist protocol of patients who underwent in vitro fertilization. Methods ： A retrospective analyse referred patients who subjected to IVF between August 2006 and August 2007 were divided into two group and compare their clinic result. The study group： 54 patients were subjected to a protocol of gonadotropin -releasing hormone antagonist. The control group： 155 patients were subjected to a long protocol of gonadotropin - releasing hormone agonist. Results ： The two groups were similar with respect to the doses of gonadotrophins （ HMG and/or rFSH） , the thickness of endometrium, the ratio of fertilization and the ratio of cleavage. Significant differences （ P 〈 0. 05） were found regarding the duration of administration, the profile of hormone level on the day of HCG adminis- tration （ E2 ） , the number of retrieved oocyte, the rate of embryo freezing, the implantation rate of embryo, the pregnancy rate and the incidence rate of OHSS. Conclusion ： We demonstrated that regimen of GnRH antagonist in patients undergoing IVF shorten the du- ration of administration and greatly reduced the treatment cost, especially the incidence rate of OHSS was decreased significantly. But the rate of embryo freezing and the pregnancy rate were lower compared With the regimen of GnRH agonist long protocol.