促性腺素释放素拮抗剂在体外受精-胚胎移植中的应用

Using of gonadotropin releasing hormone antagonist in in vitro fertilization and embryo transfer

目的:探讨促性腺素释放素拮抗剂(GnRHanta)在体外受精-胚胎移植中应用的效果。方法:回顾性分析2003年3月至2004年8月在我院生殖中心进行的384个体外受精-胚胎移植周期。研究组使用GnRHanta方案,共60个周期;对照组使用常规促性腺素释放素类似物(GnRHa)长方案,共324个周期。比较2组促排卵、受精、胚胎发育的情况和妊娠结局。结果:研究组使用促性腺素(Gn)共(2625±s 895)IU,明显少于对照组(3075±775)IU(P<0.01),而卵裂率和三级胚胎数较对照组增加(P<0.05, P<0.01)。而2组间使用Gn日数,获卵数,受精率,移植胚胎数,妊娠结局及中、重度卵巢过度刺激综合征发生率等比较,差异均无显著意义(P>0.05)。结论:GnRHanta为我们提供了一种简单、经济、有效和安全的控制性超排卵方案,值得在体外受精-胚胎移植中推广。

AIM： To evaluate the efficacy of gonadotropin releasing hormone antagonist （GnRHanta） in in vitro fertilization and embryo transfer. METHODS： Data of 384 cycles of in vitro fertilization and embryo transfer performed in our Reproductive Medicine Center from March 2003 to August 2004, were analyzed retrospectively. Patients were divided into two groups： study group, 60 cycles using GnRHanta for controlled ovarian hyperstimulation; control group, 324 cycles using GnRH analogue （GnRHa） for controlled ovarian hyperstimulation. RESULTS： The dose of gonadotrophin used in study group, （2 625 ± s 895） IU, was much less than that in control group （ （3 075 ± 775） IU, P 〈 0.01 ） . The cleavage rate and the number of grade Ⅲ embryo in study group increased more than those in control group （P 〈 0.05, P 〈 0.01 ） . There were no statistical differences in the durations of treatment, the amounts of oocyte retrieved, the rates of luteal hormone （LH） surge occurring, the rates of ovulating before oocyte retrieved, the fertilization rates, the number of grade Ⅰ / Ⅱ/Ⅲ embryos, outcomes of pregnancy, and the rates of ovarian hyperstimulation syndrome between the two groups （P 〉 0.05） . CONCLUSION： GnRHanta protocol is a simple, economic, and effective protocol, and deserves to be popularized in in vitro fertilization and embryo transfer.