GnRH-a和HCG在诱发排卵中的作用比较研究

The effective comparision of GnRH-a and HCG on ovulation induction

目的比较促性腺激素释放激素激动剂（gonadotropic releasing hormone agonist,GnRH-a）和人绒毛膜促性腺激素（human chorionic gonadotrophin,HCG）在不孕症患者诱发排卵治疗中模拟黄体生成素（luteinizing hormone,LH）峰的作用。方法在广西人口和计划生育研究中心就医的66例排卵障碍行促排卵治疗的患者,选取80个在优势卵泡成熟时未能出现预期LH峰的促排卵周期,随机分为两组,一组注射HCG6000~10000IU,共40个周期,另一组注射GnRH-a（醋酸曲谱瑞林）0.1mg,共40个周期,以模拟LH峰诱发排卵。比较注射GnRH-a和HCG两组患者间的排卵率、妊娠率、未破卵泡黄素化、黄体不足、卵巢过度刺激综合征（ovarian hyper stimulation syndrome,OHSS）、多胎妊娠和下周期囊肿发生率等指标。结果两组患者的排卵率、妊娠率、未破卵泡黄素化、黄体不足发生率、多胎发生率、差异均无统计学意义,但注射GnRH-a组的OHSS发生率、下周期囊肿发生率显著低于注射HCG组。结论在诱发排卵模拟LH峰时,使用GnRH-a比HCG更接近自然周期。

Objective To study the effect of gonadotropic releasing hormone agonist（GnRH-a）and human chorionic gonadotrophin（HCG）on simulation of LH surge on ovulation induction in infertilities.Methods Eighty treatment cycles of 66 ovulation failure patients were detected to the leading follicle diameter and the endometrial thickness by transvaginal ultrasound,urinary luteinizing hormone（LH）and basal body temperature（BBT）.The cycles which leading follicle were matured but no LH surge occurred were injected with HCG 6 000～10 000 IU（HCG group,40 cycles）or GnRH-a 0.1mg（Triptorelin group,40 cycles）to simulated LH surge to induced ovulation.The ovulation rates,pregnancy rates,luteinized unruptured follicle rates,corpus luteum insufficiency rates,ovarian hyperstimulation syndrome（OHSS）rates,next cycle cysts incidence and multiplets rates of the two groups were compared.Results There were no significant differences in the ovulation rates,pregnancy rates,luteinized unruptured follicle rates,corpus luteum insufficiency rates,and multiplets rates between two groups,but there were significant lower in ovarian hyperstimulation syndrome（OHSS）rates and next cycle cysts incidence of GnRH-a group than that of HCG group.Conclusion GnRH-a is more natural than HCG to simulate LH surge in ovulation induction.