2018 Vol. 39 (3): 405-412
供卵丶三代试管婴儿 微信：dyivf360
捐卵微信：dyivf360
摘要
【目的】探讨不同剂量促性腺激素激动剂（GnRH-α）对卵巢储备功能正常的不孕女性垂体降调程度 及体外受精与胚胎移植（IVF-ET）妊娠结局的影响。
【方法】63名年龄<35岁卵巢储备功能正常丶拟行GnRH-α长 方案助孕的不孕患者，按曲普瑞林的剂量随机分为三组降调节，0.05 mg/d，0.1 mg/d和1.25 mg单次，达到降调标 准后常规予高纯度的尿促性腺激素（HMG-HP）促排卵，比较各组降调节程度及IVF结局。
【结果】
三组在注射 GnRH-α后均达到降调节标准，达到降调节的平均天数，降调节后启动日的LH丶E2水平，窦卵泡总数丶<4 mm及 8～9 mm的窦卵泡数差异无统计学意义。启动日当天，三组间血FSH水平差异具有显著统计学意义［（3.92±1.12）U vs.（3.03±1.14）U vs.（2.05±1.12）U，P<0.001］。
短效0.05 mg组在GnRH-α注射4 h后，血清FSH丶LH水平均高于 短效0.1 mg组。达到降调标准后，三组Gn启动剂量丶使用时间及使用总量相似的情况下，hCG日直径14～18 mm 卵泡数［（3.91±2.12）个 vs.（5.81±3.55）个 vs.（6.43±3.39）个，P<0.001］丶≥18 mm/≥10 mm 卵泡数比例［（33.1%± 13.2%）vs.（24.0%±12.4%）vs.（30.1%±12.2%），P<0.05］，差异具有统计学意义。0.05 mg组hCG日LH水平明显高 于0.1 mg组与1.25 mg组［（2.47±1.33）U vs.（1.80±0.69）U vs.（1.43±0.53）U，P<0.05］，但三组均未出现早发LH峰 和提前排卵。
尽管三组获卵数差异存在统计学意义，分别为［（10.14±4.80）个vs.（11.51±2.42）个 vs.（12.79±2.73）个， P<0.05］，但三组之间MII卵子数相似，且0.05 mg组的E2水平/获卵数水平明显高于其他两组［（282.33±42.13）U vs.（221.62±32.02）U vs.（200.03±37.89）U，P<0.001］。三组新鲜周期活产率分别为61.9%丶55.0%和50.0%，每取卵 周期累积活产率分别为85.7%丶76.2%和75.0%，0.05 mg组的临床妊娠率丶活产率丶累积临床妊娠率及累积活产率 较0.1 mg组丶1.25 mg组有升高趋势。
【结论】对于卵巢储备功能正常的年轻不孕女性，GnRH-α用量减少，达到降 调后，垂体降调程度减轻，hCG日LH水平升高，虽然获卵数减少，但E 2 水平/获卵数显著升高，新鲜移植周期活产 率及取卵周期的累积活产率均有升高趋势。
关键词 ： 促性腺激素释放激素激动剂（GnRH-α）, 体外授精与胚胎移植, 垂体降调节
Abstract：【Objective】To investigate the effects of different doses of gonadotropin releasing hormone agonist（GnRH-α） on the down-regulation of normal ovarian reserve，and compared the down-regulation level as well as the clinical outcome of in vitro fertilization and embryo transfer（IVF-ET）cycles.【Methods】This RCT study included 63 infertility couples of age<35 yrs. women with normal ovarian reserve function who were intended to received GnRH-α long protocol treatment. Of the 63 women were randomly divided into three groups according to the dose of triptorelin，21 received daily 0.05 mgshort-acting GnRH-α，21 received daily 0.1 mg short-acting GnRH-α，while 21 received reduced -dose depot of 1.25 mg GnRH-α.【Results】In the three groups，the average duration of down-regulation reached after injection of GnRH- α，the level of LH and E 2 ，the total number of antral follicles，the number of antral follicles of <4 mm and 8~9 mm were similar. The serum follicle-stimulating hormone level on the day of gonadotropin initiation were significantly higher in the two short-acting groups compared with the long-acting group［（3.92±1.12）U vs.（3.03±1.14）U vs.（2.05±1.12）U，P< 0.001］. Four hours after the GnRHa injection，the serum FSH，LH levels were higher in short-acting 0.05 mg group than the short-acting short-acting 0.1 mg group. Both number of days of gonadotropin stimulation and gonadotropin doses were similar in three groups. On the day of hCG administration，the numbers of 14-18mm diameter follicles［（3.91±2.12）vs. （5.81±3.55）vs.（6.43±3.39），P<0.001］as well as the proportion of follicles with diameter ≥18 mm/≥10 mm［（33.1%± 13.2%）vs.（24.0%±12.4%）vs.（30.1%±12.2%），P<0.05］，were both statistically significant different in three groups. Although serum LH level on hCG day was significantly increased in 0.05 mg group［（2.47±1.33）U vs.（1.80±0.69）U vs. （1.43±0.53）U，P<0.05］. No premature LH surge and premature ovulation was observed. The number of retrieved oocytes was significant different［（10.14±4.80）vs.（11.51±2.42）vs.（12.79±2.73），P<0.05］. However，no significant differences was found regard to the number of MII oocytes，and the serum estrogen level per egg was significant higher in 0.05 mg group［（282.33±42.13）U vs.（221.62±32.02）U vs.（200.03±37.89）U，P<0.001］. The live birth rate（LBR）of these three groups in fresh cycles were 61.9%，55.0%，and 50.0%，respectively. The cumulative LBR were 85.7%，76.2%， and 75.0%，respectively.A increased trend was observed in the clinical pregnancy rate，cumulative clinical pregnancy rate and cumulative LBR in 0.05 mg group than the other two groups.【Conclusion】For women with normal ovarian reserve，as the GnRH-α dosage decreased，the down-regulation of pituitary reduced，while serum LH levels on the day of hCG trigger increased. The number of oocytes retrieved was decreased，the proportion of cycles which retrieved ＞15 oocytes was also lower. However，the average estrogen level per egg was significant increased，and a better clinical out? come of IVF-ET was received.
Key words： gonadotropin releasing hormone agonist in vitro fertilization and embryo transfer pituitary down-regulation
供卵丶三代试管婴儿 微信：dyivf360
捐卵微信：dyivf360
摘要
【目的】探讨不同剂量促性腺激素激动剂（GnRH-α）对卵巢储备功能正常的不孕女性垂体降调程度 及体外受精与胚胎移植（IVF-ET）妊娠结局的影响。
【方法】63名年龄<35岁卵巢储备功能正常丶拟行GnRH-α长 方案助孕的不孕患者，按曲普瑞林的剂量随机分为三组降调节，0.05 mg/d，0.1 mg/d和1.25 mg单次，达到降调标 准后常规予高纯度的尿促性腺激素（HMG-HP）促排卵，比较各组降调节程度及IVF结局。
【结果】
三组在注射 GnRH-α后均达到降调节标准，达到降调节的平均天数，降调节后启动日的LH丶E2水平，窦卵泡总数丶<4 mm及 8～9 mm的窦卵泡数差异无统计学意义。启动日当天，三组间血FSH水平差异具有显著统计学意义［（3.92±1.12）U vs.（3.03±1.14）U vs.（2.05±1.12）U，P<0.001］。
短效0.05 mg组在GnRH-α注射4 h后，血清FSH丶LH水平均高于 短效0.1 mg组。达到降调标准后，三组Gn启动剂量丶使用时间及使用总量相似的情况下，hCG日直径14～18 mm 卵泡数［（3.91±2.12）个 vs.（5.81±3.55）个 vs.（6.43±3.39）个，P<0.001］丶≥18 mm/≥10 mm 卵泡数比例［（33.1%± 13.2%）vs.（24.0%±12.4%）vs.（30.1%±12.2%），P<0.05］，差异具有统计学意义。0.05 mg组hCG日LH水平明显高 于0.1 mg组与1.25 mg组［（2.47±1.33）U vs.（1.80±0.69）U vs.（1.43±0.53）U，P<0.05］，但三组均未出现早发LH峰 和提前排卵。
尽管三组获卵数差异存在统计学意义，分别为［（10.14±4.80）个vs.（11.51±2.42）个 vs.（12.79±2.73）个， P<0.05］，但三组之间MII卵子数相似，且0.05 mg组的E2水平/获卵数水平明显高于其他两组［（282.33±42.13）U vs.（221.62±32.02）U vs.（200.03±37.89）U，P<0.001］。三组新鲜周期活产率分别为61.9%丶55.0%和50.0%，每取卵 周期累积活产率分别为85.7%丶76.2%和75.0%，0.05 mg组的临床妊娠率丶活产率丶累积临床妊娠率及累积活产率 较0.1 mg组丶1.25 mg组有升高趋势。
【结论】对于卵巢储备功能正常的年轻不孕女性，GnRH-α用量减少，达到降 调后，垂体降调程度减轻，hCG日LH水平升高，虽然获卵数减少，但E 2 水平/获卵数显著升高，新鲜移植周期活产 率及取卵周期的累积活产率均有升高趋势。
关键词 ： 促性腺激素释放激素激动剂（GnRH-α）, 体外授精与胚胎移植, 垂体降调节
Abstract：【Objective】To investigate the effects of different doses of gonadotropin releasing hormone agonist（GnRH-α） on the down-regulation of normal ovarian reserve，and compared the down-regulation level as well as the clinical outcome of in vitro fertilization and embryo transfer（IVF-ET）cycles.【Methods】This RCT study included 63 infertility couples of age<35 yrs. women with normal ovarian reserve function who were intended to received GnRH-α long protocol treatment. Of the 63 women were randomly divided into three groups according to the dose of triptorelin，21 received daily 0.05 mgshort-acting GnRH-α，21 received daily 0.1 mg short-acting GnRH-α，while 21 received reduced -dose depot of 1.25 mg GnRH-α.【Results】In the three groups，the average duration of down-regulation reached after injection of GnRH- α，the level of LH and E 2 ，the total number of antral follicles，the number of antral follicles of <4 mm and 8~9 mm were similar. The serum follicle-stimulating hormone level on the day of gonadotropin initiation were significantly higher in the two short-acting groups compared with the long-acting group［（3.92±1.12）U vs.（3.03±1.14）U vs.（2.05±1.12）U，P< 0.001］. Four hours after the GnRHa injection，the serum FSH，LH levels were higher in short-acting 0.05 mg group than the short-acting short-acting 0.1 mg group. Both number of days of gonadotropin stimulation and gonadotropin doses were similar in three groups. On the day of hCG administration，the numbers of 14-18mm diameter follicles［（3.91±2.12）vs. （5.81±3.55）vs.（6.43±3.39），P<0.001］as well as the proportion of follicles with diameter ≥18 mm/≥10 mm［（33.1%± 13.2%）vs.（24.0%±12.4%）vs.（30.1%±12.2%），P<0.05］，were both statistically significant different in three groups. Although serum LH level on hCG day was significantly increased in 0.05 mg group［（2.47±1.33）U vs.（1.80±0.69）U vs. （1.43±0.53）U，P<0.05］. No premature LH surge and premature ovulation was observed. The number of retrieved oocytes was significant different［（10.14±4.80）vs.（11.51±2.42）vs.（12.79±2.73），P<0.05］. However，no significant differences was found regard to the number of MII oocytes，and the serum estrogen level per egg was significant higher in 0.05 mg group［（282.33±42.13）U vs.（221.62±32.02）U vs.（200.03±37.89）U，P<0.001］. The live birth rate（LBR）of these three groups in fresh cycles were 61.9%，55.0%，and 50.0%，respectively. The cumulative LBR were 85.7%，76.2%， and 75.0%，respectively.A increased trend was observed in the clinical pregnancy rate，cumulative clinical pregnancy rate and cumulative LBR in 0.05 mg group than the other two groups.【Conclusion】For women with normal ovarian reserve，as the GnRH-α dosage decreased，the down-regulation of pituitary reduced，while serum LH levels on the day of hCG trigger increased. The number of oocytes retrieved was decreased，the proportion of cycles which retrieved ＞15 oocytes was also lower. However，the average estrogen level per egg was significant increased，and a better clinical out? come of IVF-ET was received.
Key words： gonadotropin releasing hormone agonist in vitro fertilization and embryo transfer pituitary down-regulation
最新评论
7509用户6765117894
2019/05/05
感谢分享，最好是先去了解一下，我是朋友介绍的，微信【cfbb1818】，是在这约的对比了好多家还是这家靠谱，国内和海外都有知名的医院和诊所，提供捐精丶供卵试管婴儿专业丶权威丶可信赖的高端服务。之前对比了好多家，还是这家好，比较靠谱，幸好选对了，一次成功，真的很感恩，大家可以了解一下
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