长方案中小剂量曲普瑞林对体外受精胚胎移植者垂体降调节的效果观察

Effect of Low-dose Triptorelin on Pituitary Down-regulation forPatients Undergoing in vitro Fertilization and Embryo Transfer

目的 :观察小剂量曲普瑞林黄体后期给药对体外受精 胚胎移植者垂体降调节的效果。 方法 :1 2 0例病人随机分成两组。A组于月经第 2 1d起每日皮下注射曲普瑞林 0 .1mg ,共 7d ;B组采用贝苏林喷鼻长方案。比较两组超排卵周期第 3d(D3)和绒毛膜促性腺激素 (hCG)注射日血清性激素水平及高纯度促卵泡素 (HP)用药剂量等指标。 结果 :A组D3和hCG注射日平均血清黄体生成素 (LH)水平分别为 (1 .55± 0 .99)U/L和 (2 .70± 1 .45)U/L ,血清雌二醇 (E2 )水平分别为 (85 .66± 48.1 9)pmol/L和 (5 451 .31± 1 90 0 .61 )pmol/L ,显著低于B组 (P <0 .0 0 1 ;P <0 .0 1 ;P <0 .0 5 ;P <0 .0 0 1 ) ;而A组平均每周期用HP(2 8.2 0± 1 1 .0 3)支 ,显著高于B组用量 [(2 2 .30± 6 .39)支 ,P<0 .0 0 1 ) ]。 结论

Objective: To observe the effect of low dose triptorelin in later luteal phase on pituitary down regulation for patients undergoing IVF ET. Methods: One hundred and twenty patients were randomly divided into 2 groups(A and B). In group A, the patients were treated with triptorelin of 0.1 mg subcutaneously daily started on day 21 of menstrual cycle for 7 days. In group B, the patients were treated with long protocol of Buserelin intranasal spray. Comparisons were made between the groups in serum concentrations of FSH, LH, E2, T, PRL and P on the third day (D3) of superovulation cycle and on the day of hCG administration, highly purified follicle stimunating hormone (HP) dosages, and so on. Results: In group A, mean serum LH level on D3 and the day of hCG was ( 1.55 ± 0.99 ) U/L and ( 2.70 ± 1.45 ) U/L, E2 was ( 85.66 ± 13.13 ) pmol/L and ( 5 451.31 ± 1 900.61 ) pmol/L, respectively, significantely lower than those of group B ( P < 0.001 ; P < 0.01 ; P < 0.05 ; P < 0.001 ). Mean HP(75 IU/ Amp) dosage per treatment cycle in group A was 28.20 ± 11.03 ampoules, significantly higher than 22.30 ± 6.40 ampoules in group B( P < 0.001 ). Conclusions: Low dose triptorelin in later luteal phase is effective for down regulation of pituitary and produces more suppression on endogenous LH in pituitary than Buserelin long protocl.