The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cy...The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.展开更多
Objective To compare the clinical characteristics in a gonadotropin (Gn) and medroxyprogestrone acetate (MPA) protocol using three types of Gn in normal ovulatory women undergoing IVF/ICSI treatments. Methods A to...Objective To compare the clinical characteristics in a gonadotropin (Gn) and medroxyprogestrone acetate (MPA) protocol using three types of Gn in normal ovulatory women undergoing IVF/ICSI treatments. Methods A total of 258 normal ovulatory IVF/ICSI patients undergoing ovarian stimulation in a Gn and MPA protocol were analyzed in this retrospective study and allocated into three groups according to the Gn used: group A, hMG-A (brand name: Fengyuan, n=105); group B, hMG-B (brand name: Lebaode, n=90); group C: u-FSH (brand name: Lishenbao, n=63). The hormone profile, embryological characteristics, and the pregnant results after frozen-thawed embryo transfer (FET) were compared among the three groups. Results There was no significant difference in the number of oocytes retrieved among the three groups (12.1± 6.9 vs 12.1±5.6 vs 13.1 ±8.8, P〉0.05). Other indicators such as the number of mature oocyte, fertilization, cleavage and viable embryo were similar (P〉0.05). No premature LH surges were detected, with a range of 0.04-7.38 IU/L. No differences were found in the clinical pregnancy rate per transfer (43.48% vs 37.93% vs 40. 74%, P〉0.05) and the implantation rate (34.88% vs 22.22% vs 26.42%, P〉O.05). Conclusion MPA is an effective oral alternative for the prevention of premature LH surges. Progestin-primed ovarian stimulation (PPOS) is a novel regimen of ovarian stimulation in combination with embryo cryopreservation, in which the two types of hMG are as effective as u-FSH.展开更多
基金Hainan Province Major Science and Technology Plan Projects(No.ZDKJ2021037,ZDKJ2017007)National Natural Science Foundation of China(No.81960283),and Co-funded by the Hainan Provincial Academician Innovation Platform Research Project and the Hainan Provincial Clinical Medicine Center Construction Project。
文摘The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.
文摘Objective To compare the clinical characteristics in a gonadotropin (Gn) and medroxyprogestrone acetate (MPA) protocol using three types of Gn in normal ovulatory women undergoing IVF/ICSI treatments. Methods A total of 258 normal ovulatory IVF/ICSI patients undergoing ovarian stimulation in a Gn and MPA protocol were analyzed in this retrospective study and allocated into three groups according to the Gn used: group A, hMG-A (brand name: Fengyuan, n=105); group B, hMG-B (brand name: Lebaode, n=90); group C: u-FSH (brand name: Lishenbao, n=63). The hormone profile, embryological characteristics, and the pregnant results after frozen-thawed embryo transfer (FET) were compared among the three groups. Results There was no significant difference in the number of oocytes retrieved among the three groups (12.1± 6.9 vs 12.1±5.6 vs 13.1 ±8.8, P〉0.05). Other indicators such as the number of mature oocyte, fertilization, cleavage and viable embryo were similar (P〉0.05). No premature LH surges were detected, with a range of 0.04-7.38 IU/L. No differences were found in the clinical pregnancy rate per transfer (43.48% vs 37.93% vs 40. 74%, P〉0.05) and the implantation rate (34.88% vs 22.22% vs 26.42%, P〉O.05). Conclusion MPA is an effective oral alternative for the prevention of premature LH surges. Progestin-primed ovarian stimulation (PPOS) is a novel regimen of ovarian stimulation in combination with embryo cryopreservation, in which the two types of hMG are as effective as u-FSH.