长效和短效促性腺激素释放激素激动剂在垂体降调中的应用

The application of long-and short-acting forms of gonadotrophin-releasing hormone agonists in pituitary down-regulation

促性腺激素释放激素激动剂(GnRH-a)已经广泛应用在体外受精治疗周期中。在长方案垂体降调中,或每天使用低剂量短效GnRH-a或使用高剂量的长效GnRH-a来达成垂体脱敏。与短效方案相比,长效GnRH-a会增加促性腺激素(Gn)的用量和作用时间,且孕酮水平有升高趋势。孕酮水平的升高与卵泡刺激素(FSH)和黄体生成素(LH)作用下卵泡内的孕酮转化有关。然而,孕酮水平升高与主导卵泡径线的关系有待更多的研究证据。

Gonadotrophin-releasing hormone agonists （GnRH-a）have been widely used in the treatment of in vitro fertilization. There are two types of GnRH-a administration that can be used to lead to pituitary desensitization in the long protocol, one consisting of daily low doses of GnRH-a and the other consisting of higher, long-acting doses. The use of long-acting GnRH-a for pituitary desensitization in IVF cycles increases the number of gonadotrophin ampoules and the duration of the ovarian stimulation as compared with the use of short-acting GnRH-a. The elevated progesterone （P） level before hCG injection is related to the high FSH exposure and low LH level. However, the relationship between the elevated P level and lead follicular size still need more research.