GnRH agonist(GnRH-a) and GnRH antagonist(GnRH-ant) play important roles in in-vitro fertilization and embryo transfer(IVF-ET).The effect of GnRH-a was affirmed during twenty years’use.The application of GnRH-ant was ...GnRH agonist(GnRH-a) and GnRH antagonist(GnRH-ant) play important roles in in-vitro fertilization and embryo transfer(IVF-ET).The effect of GnRH-a was affirmed during twenty years’use.The application of GnRH-ant was comparatively less because some advantages of GnRH-a has not been recognized and now researchers pay much attention on it.So,its useness become more and more in the cycles of controlled ovarian stimulation(COS).Up to now,identical conclusion on which kind of the GnRH analogue is more superior for the results of IVF-ET has not been got.As for GnRH-ant,much investigation should be done and a lot of biological rationale and convincing clinic data should be acquired so as to proving which will be better.展开更多
Objective: To analyze the distribution of oocytes nuclear maturational stages and intracytoplasmic sperm injection (ICSI) outcome in relation to follicular size, after controlled ovarian hyperstimulation (COH), using ...Objective: To analyze the distribution of oocytes nuclear maturational stages and intracytoplasmic sperm injection (ICSI) outcome in relation to follicular size, after controlled ovarian hyperstimulation (COH), using gonadotropin- releasing hormone (GnRH) antagonist or agonist protocols. Design: Prospective comparative study. Setting: Fertility unit in an academic hospital. Patient(s): Normo- ovulatory patients with unexplained, male and/or tubal factor infertility undergoing ICSI treatment. Intervention(s): Oocytes were retrieved from small (7- 12 mm) and large follicles (>12 mm). Main Outcome Measure(s): Oocyte nuclear maturation stage, fertilization and preimplantation embryonic development of the mature ova evaluated. Result(s): Distribution of oocyte maturation stages from small follicles did not differ between the two COH protocols. From large follicles, a statistically significantly higher percentage of immature oocytes was retrieved after antagonist compared with agonist treatment (16 vs 11% , respectively). No statistically significant differences existed regarding ICSI outcome of mature ova within the same follicle diameter range between COH protocols. Inseminated ova from small follicles presented a significantly higher number of embryos with delayed development on day 3 after ICSI. Conclusion(s): A greater heterogeneity of maturity was found in the population of oocyte stages that were present after the antagonist protocol. Matured oocytes retrieved from small follicles generated embryos of lower developmental potential than oocytes derived from larger follicles.展开更多
Objective: To compare levels of apoptosis in granulosa cells from women treated with the gonadotropin- releasing hormone (GnRH) agonist triptorelin or the GnRH antagonist cetrorelix. Design: Randomized, prospective st...Objective: To compare levels of apoptosis in granulosa cells from women treated with the gonadotropin- releasing hormone (GnRH) agonist triptorelin or the GnRH antagonist cetrorelix. Design: Randomized, prospective study. Setting: University hospital. Patient(s): Thirty- two women undergoing assisted reproduction techniques after ovulation induction with recombinant follicle- stimulating hormone (FSH) plus GnRH agonist or antagonist. Intervention(s): Granulosa cells were isolated from follicular aspirates after oocyte removal. Main Outcome Measure(s): Apoptosis was assessed with Annexin V binding assay, terminal deoxynucleotidyl transferase (TdT)- mediated nick- end labeling (TUNEL) assay, flow cytometric analysis of DNA, and ultrastructural analysis of cell morphology in transmission electron microscopy. Serum and follicular hormonal levels were also determined. Result(s): Annexin V binding and TUNEL assays revealed comparable percentages of apoptosis in the two groups under investigation. Analysis of DNA histograms revealed a similar cell cycle distribution in the two groups. Ultrastructural analysis only occasionally displayed patterns of chromatin margination in apoptotic cells. The mean concentrations of all the follicular fluid steroid hormones evaluated (E2, T, and P) were significantly lower in the GnRH antagonist- treated group. Conclusion(s): Therapy with a GnRH agonist or antagonist is associated with comparable levels of apoptosis in granulosa cells.展开更多
Objective: To compare the efficacy of GnRH antagonist vs. GnRH agonist adminis tration for controlled ovarian hyperstimulation (COH) in assisted reproduction. Design: A prospective, randomized trial. Setting: Clinical...Objective: To compare the efficacy of GnRH antagonist vs. GnRH agonist adminis tration for controlled ovarian hyperstimulation (COH) in assisted reproduction. Design: A prospective, randomized trial. Setting: Clinical research unit at a te rtiary care medical center. Patient(s): Sixty-five patients with unexplained in fertility or mild male subfertility undergoing COH for IUI. Intervention(s): Twe nty-nine women (group A) were randomized to receive 600 μg of busereline aceta te per day starting in the midluteal phase of the cycle (long protocol), whereas 36 women (group B) were treated with 0.25 mg/d of the GnRH antagonist Cetroreli x starting from day 6 of the cycle. The starting dose of recombinant FSH was 150 IU in women of both groups. Insemination was performed 34 hours after hCG injec tion. Main Outcome Measure(s): Clinical and successful ongoing pregnancy rate (P R), measurements of serum FSH, LH, E2, and P, number of recruited follicles, dur ation of stimulation period, and amount of gonadotropins used. Result(s): Women in group A required significantly more days of treatment (median: 12.0 vs. 9.0) and significantly more total units of recombinant FSH (median 1,800 vs. 1,550) a s compared with the corresponding values of the antagonist group (group B). Seru m FSH, LH, E2, and P were significantly higher on the antagonist group on days 2 and 6 of stimulation. However, these differences regress until the day of hCG a dministration. Conclusion(s): The GnRH antagonists have facilitated short and si mple treatment, and are particularly attractive for administration in women unde rgoing COH, achieving comparable PR with the long protocol regimen.展开更多
文摘GnRH agonist(GnRH-a) and GnRH antagonist(GnRH-ant) play important roles in in-vitro fertilization and embryo transfer(IVF-ET).The effect of GnRH-a was affirmed during twenty years’use.The application of GnRH-ant was comparatively less because some advantages of GnRH-a has not been recognized and now researchers pay much attention on it.So,its useness become more and more in the cycles of controlled ovarian stimulation(COS).Up to now,identical conclusion on which kind of the GnRH analogue is more superior for the results of IVF-ET has not been got.As for GnRH-ant,much investigation should be done and a lot of biological rationale and convincing clinic data should be acquired so as to proving which will be better.
文摘Objective: To analyze the distribution of oocytes nuclear maturational stages and intracytoplasmic sperm injection (ICSI) outcome in relation to follicular size, after controlled ovarian hyperstimulation (COH), using gonadotropin- releasing hormone (GnRH) antagonist or agonist protocols. Design: Prospective comparative study. Setting: Fertility unit in an academic hospital. Patient(s): Normo- ovulatory patients with unexplained, male and/or tubal factor infertility undergoing ICSI treatment. Intervention(s): Oocytes were retrieved from small (7- 12 mm) and large follicles (>12 mm). Main Outcome Measure(s): Oocyte nuclear maturation stage, fertilization and preimplantation embryonic development of the mature ova evaluated. Result(s): Distribution of oocyte maturation stages from small follicles did not differ between the two COH protocols. From large follicles, a statistically significantly higher percentage of immature oocytes was retrieved after antagonist compared with agonist treatment (16 vs 11% , respectively). No statistically significant differences existed regarding ICSI outcome of mature ova within the same follicle diameter range between COH protocols. Inseminated ova from small follicles presented a significantly higher number of embryos with delayed development on day 3 after ICSI. Conclusion(s): A greater heterogeneity of maturity was found in the population of oocyte stages that were present after the antagonist protocol. Matured oocytes retrieved from small follicles generated embryos of lower developmental potential than oocytes derived from larger follicles.
文摘Objective: To compare levels of apoptosis in granulosa cells from women treated with the gonadotropin- releasing hormone (GnRH) agonist triptorelin or the GnRH antagonist cetrorelix. Design: Randomized, prospective study. Setting: University hospital. Patient(s): Thirty- two women undergoing assisted reproduction techniques after ovulation induction with recombinant follicle- stimulating hormone (FSH) plus GnRH agonist or antagonist. Intervention(s): Granulosa cells were isolated from follicular aspirates after oocyte removal. Main Outcome Measure(s): Apoptosis was assessed with Annexin V binding assay, terminal deoxynucleotidyl transferase (TdT)- mediated nick- end labeling (TUNEL) assay, flow cytometric analysis of DNA, and ultrastructural analysis of cell morphology in transmission electron microscopy. Serum and follicular hormonal levels were also determined. Result(s): Annexin V binding and TUNEL assays revealed comparable percentages of apoptosis in the two groups under investigation. Analysis of DNA histograms revealed a similar cell cycle distribution in the two groups. Ultrastructural analysis only occasionally displayed patterns of chromatin margination in apoptotic cells. The mean concentrations of all the follicular fluid steroid hormones evaluated (E2, T, and P) were significantly lower in the GnRH antagonist- treated group. Conclusion(s): Therapy with a GnRH agonist or antagonist is associated with comparable levels of apoptosis in granulosa cells.
文摘Objective: To compare the efficacy of GnRH antagonist vs. GnRH agonist adminis tration for controlled ovarian hyperstimulation (COH) in assisted reproduction. Design: A prospective, randomized trial. Setting: Clinical research unit at a te rtiary care medical center. Patient(s): Sixty-five patients with unexplained in fertility or mild male subfertility undergoing COH for IUI. Intervention(s): Twe nty-nine women (group A) were randomized to receive 600 μg of busereline aceta te per day starting in the midluteal phase of the cycle (long protocol), whereas 36 women (group B) were treated with 0.25 mg/d of the GnRH antagonist Cetroreli x starting from day 6 of the cycle. The starting dose of recombinant FSH was 150 IU in women of both groups. Insemination was performed 34 hours after hCG injec tion. Main Outcome Measure(s): Clinical and successful ongoing pregnancy rate (P R), measurements of serum FSH, LH, E2, and P, number of recruited follicles, dur ation of stimulation period, and amount of gonadotropins used. Result(s): Women in group A required significantly more days of treatment (median: 12.0 vs. 9.0) and significantly more total units of recombinant FSH (median 1,800 vs. 1,550) a s compared with the corresponding values of the antagonist group (group B). Seru m FSH, LH, E2, and P were significantly higher on the antagonist group on days 2 and 6 of stimulation. However, these differences regress until the day of hCG a dministration. Conclusion(s): The GnRH antagonists have facilitated short and si mple treatment, and are particularly attractive for administration in women unde rgoing COH, achieving comparable PR with the long protocol regimen.
