“卵泡期长方案”中添加LH是必须的吗?

Is LH supplementation necessary in the follicular-phase long protocol?

体外受精-胚胎移植(IVF-ET)治疗过程中,促性腺激素释放激素激动剂(GnRH-a)降调节方案不断在改进。一些生殖中心采用"卵泡期长方案",该方案简单、方便,月经第2天给予一支长效GnRH-a(3.75mg),4~7周时启动药物刺激卵巢,临床结局良好,几乎成为标准流程。然而,促性腺激素(Gn)使用时,是否选择LH?如何用?仍在争论中。由于基础状态的个体化表现,对降调的反应不同,垂体被抑制程度迥异,垂体恢复速度亦快慢不一,生长卵泡对外源性Gn的敏感性截然不同,对FSH和/或LH的需求及剂量差别很大,故Gn的选择和剂量及刺激时间大相径庭。

The down-regulation protocols with Gonadotropin-releasing hormone agonist（GnRH-a）is developing in the in vitro fertilization-embryo transfer（IVF-ET）treatment.Long down-regulation protocol of early follicular phase is adopted in some centers as standard treatment because of the convenience and satisfactory outcome.In this kind of protocol a single dose（3.75 mg）of GnRH-a is used on the second day of the menstrual cycle and after that the gonadotropins are used during the fourth and seventh week.However,the effect of rLH on pregnancy outcome is controversial.Ovarian responce varies among patients,as a result the suppression of pituitaries are different.Because of the variance in responces of growing follicles on exogenous gonadotropin,the selection of the kind and the duration of gonadotropins are individual.