不同拮抗剂体外受精-胚胎移植临床结局比较

Comparison of the clinical outcomes of different antagonists in vitro fertilization-embryo transfer

目的:比较拮抗剂方案中注射用醋酸西曲瑞克(西曲瑞克)与醋酸加尼瑞克(加尼瑞克)的体外受精-胚胎移植(IVF-ET)临床结局。方法:回顾性分析2017年1月至2018年3月采用拮抗剂方案行IVF/ICSI治疗543个周期的临床资料,按控制性促排卵过程中使用的促性腺激素释放激素拮抗剂的不同,分为西曲瑞克组和加尼瑞克组,比较2组控制性促排卵(COS)及体外受精-胚胎移植(IVF-ET)临床结局。结果:2组病人年龄、不孕年限、体质量指数差异无统计学意义(P>0.05)。西曲瑞克组基础促卵泡刺激素、促性腺激素用量和拮抗剂使用时间均低于加尼瑞克组(P<0.05),基础窦状卵泡数、抗苗勒管激素及获卵数均高于加尼瑞克组(P<0.05~P<0.01),2组人绒毛膜促性腺激素日促黄体生成素(LH)水平、早发LH峰率、卵子逃逸率、取卵周期移植率、优质胚胎率、种植率、临床妊娠率及早期流产率差异均无统计学意义(P>0.05)。结论:拮抗剂方案中西曲瑞克与加尼瑞克具有相似的抑制早发LH峰效应和临床结局。

Objective:To compare the clinical outcomes between cetrorelix acetate(cetrorelix)and Ganirelix acetate(ganirelix)in vitro fertilization-emryo transfer(IVF-ET).Methods:The clinical data of 543 IVF-ET cycles treated with IVF/ICSI program from January 2017 to March 2018 were retrospectively analyzed.The patients were divided into the cetrorelix group and ganirelix group according to the gonadotropin-releasing hormone antagonist types.The clinical outcomes of controlled ovarian stimulation(COS)and IVF-ET were compared between two groups.Results:The differences of the age,infertility years and body mass index between two groups were not statistically significant(P>0.05).The basal follicle-stimulating hormone level,gonadotropin dosage and antagonist duration in cetrorelix group were significantly higher than those in ganirelix group(P<0.05).The number of basal sinusoid follicles,anti-mulller hormone and number of acquired eggs in cetrorelix group were higher than those in ganirelix group(P<0.05 to P<0.01).The differences of the chorionic gonadotropin and luteinizing hormone(LH)levels,LH peak rate of early onset,Oocyte escape rate,oocyte retrieval cycle transplantation rate,high quality embryo rate,implantation rate,clinical pregnancy rate and early abortion rate were not statistically significant(P>0.05).Conclusions:The inhibitory effects on early LH peak and clinical outcomes of antagonist regiments of cetrorelix and ganirelix are similar.