重组卵泡刺激素与高纯度尿提取卵泡刺激素在辅助生殖的疗效比较

目的　比较重组卵泡刺激素 (rFSH)与高纯度尿提取卵泡刺激素 (uFSH)在促超排卵周期中的有效性和安全性。　方法　 2 0 2例接受体外受精 胚胎移植 (IVF ET)的不育患者 ,随机分为rFSH组 1 0 0例及uFSH组 1 0 2例。两组均采用黄体期长方案促超排卵。卵泡监测、取卵、IVF、ET等均按本中心常规进行。观察两组用药时间、用药剂量、获卵数、妊娠率及重度卵巢过度刺激综合征 (OHSS)发生率等。　结果　rFSH组与uF SH组比较 ,使用FSH天数及安瓿数显著减少 (P <0 .0 5) ,分别为 ( 1 2 .5± 2 .4)及 ( 1 4 .6±1 .7)、( 2 8.7± 7.6)及 ( 3 2 .6± 4.9) ,hCG日直径 >1 0mm的卵泡数、获卵数、优质胚胎率及可冻存胚胎率显著增多 (P <0 .0 5)。临床妊娠率 (分别为 42 %及 3 7.3 % )、胚胎种植率、多胎率、重度OHSS发生率 (分别为 3 %及 2 % )无显著差异 (P >0 .0 5)。　结论　虽然两组种植率及妊娠率无差异 ,但rFSH能更有效地促卵泡生长从而获得更多数量的优质卵与胚胎

Ovarian stimulation in assisted reproductive technique: a comparison of recombinant and highly purified urinary human follicule stimulating hormone

Objective: To investigate the efficacy and safety of recombinant human FSH (rFSH, Gonal-F) and highly purified urinary human FSH (uFSH, Metrodin HP) in women undergoing controlled ovarian hyperstimulation for in-vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI). Methods: 100 and 102 infertile women were randomly assigned in the rFSH and FSH groups respectively. Following down regulation in a long gonadotrophin-releasing hormone (GnRH) agonist protocol, patients received rFSH or uFSH s.c., at a fixed dose of 150 IU, till an adequate developed follicle was achieved then received human chorionic gonadotrophin injection. Results: The duration of FSH treatment was significantly shorter in rFSH group than in uFSH (12.5±2.4 vs 14.6±1.7 days) (P<0.05) and significantly fewer ampoules of Gn were required in rFSH group(28.7±7.6 vs 32.6±4.9),( P<0.05). There were significantly more follicles≥10 mm in diameter with rFSH(15.6±8.2 vs 12.5±7.2)(P<0.05) and also more oocytes retrieved (13.2±5.7 vs 10.3±5.5)( P<0.05). Although there was no statistical difference in pregnancy rate between two groups, however patients in rFSH group had a slightly higher pregnancy rate per cycle than patients in uFSH groups (42% vs 37.3%). Moderate to severe ovarian hyperstimulation syndrome occurred in 3.0% and 2.0% of rFSH and uFSH groups respectively (not significant) Conclusion: There was no significant difference in the rates of implantation and pregnancy between two groups. However, rFSH seems more effective in inducing multifollicular development and resulting in achieving more good qualitative oocytes and embryos.