Triptorelin和Buserelin对不孕妇女体外受精一胚胎移植疗效的比较

Comparison between Triptorelin and Buserelin for in vitro fertilization program.

目的 比较GnRH -a制剂Triptorelin和Buserelin的体外受精—胚胎移植治疗效果。方法 185例不孕妇女随机分成两组 ,A组 :85例 ,黄体期应用Triptorelin(月经第 2 1d皮下一次性注射 1.2 5～ 1.6 0mg) ;B组 :10 0例 ,黄体期应用Buserelin。两组均用长方案降调节。比较两组的高纯度促卵泡刺激素用药剂量、取卵数、受精率、卵裂率和妊娠率。结果 两组的取卵数、受精率、卵裂率和妊娠率无显著性差异 (P >0 .0 5 )。A组平均每周期用高纯度卵泡刺激素 4 0 .3± 18.2支 ,B组平均每周期用 30 .2± 12 .3支 ,有显著性差异 (P <0 .0 1)。结论 Triptorelin和Buserelin的长方案均可获得高质量的成熟卵子 ,对不孕妇女的体外受精—胚胎移植治疗效果相似。Triptorelin的降调节作用较Buserelin的强。黄体期一次性皮下注射Triptorelin1.2 5～ 1.6 0mg可简化治疗过程 ,患者易于接受。

Objective: To compare the effects of GnRH agonists, Triptorelin and Buserelin, on the treatment of infertile women in in vitro fertilization(IVF) cycles. Methods: 185 infertile women were randomly divided into Triptorelin group (group A, 85 cases) and Buserelin grouup (group B, 100 cases). In group A each case was subcutaneously injected 1.25～1.60mg Triptorelin on the day 21 of the luteal phase. In group B each case was given 600μg Buserelin daily by nasal spray start in the day 21 of the luteal phase continue till hCG was given. Both groups were treated by the management with long-term GnRH down-regulation. Results: There were no significant difference on the number of oocyte obtained, fertilization rates, cleavage rates, and clinical pregnancy rates between these two groups (P>0.05). The dosage of highly purified follicular stimulating hormone in group A was more than that in group B (P<0.01). Conclusion: Triptorelin and Buserelin would have the similar efficacy in IVF treatment, and contribute the similar clinical pregnancy rates. Triptorelin has stronger effect on pituitary down-regulation than Buserelin. The Triptorelin protocol is simple, and patients would be easily treated.