减量促性腺激素释放激素激动剂在促超排卵中的应用

目的　比较控制性促超排卵中减量与常规剂量促性腺激素释放激素激动剂( Gn RHa)对于垂体降调节作用的效果。　方法　进行体外受精 -胚胎移植 ( IVF-ET)的患者随机分成两组 ,对照组 98例应用常规剂量 Gn RHa 3 .75mg,减量组 93例应用 Gn RHa1 .2 5mg。两组患者在月经周期第 1 9～ 2 1天肌注不同剂量的 Gn RHa垂体降调节 ,下次月经周期的第 2日测血雌二醇 ( E2 )、卵泡刺激素 ( FSH)及黄体生成素 ( L H)水平 ,并进入促超排卵和体外受精程序 ,比较两组的人绝经期促性腺激素 ( HMG)支数、取卵数、受精胚胎数、移植和冷冻胚胎数、生化妊娠率及药物费用。　结果　两组患者的取卵数、受精胚胎数、移植和冷冻胚胎数、妊娠率、血 E2 、FSH、L H水平无显著差异 ,HMG支数和药物费用有显著差异 ( P<0 .0 1 )。　结论　减量 Gn RHa是一种安全有效的垂体降调节方法

Application of reduced gonadotropin releasing hormone agonist in controlled ovarian hyperstimulation

Objective: To evaluate the effect of a single reduced gonadotropin releasing hormone agonist (GnRHa) 1.25 mg dose and the regular GnRHa 3.75 mg dose on pituitary down-regulation in women undergoing controlled ovarian hyperstimulation (COH). Methods: Patients underwent IVF-ET or ICSI were divided into two groups randomly: the control group with 98 cases received regular GnRHa 3.75 mg and the study group with 93 cases received GnRHa reduced dose 1.25 mg. They started treatment on menstrual cycle day 19~21. The blood levels of E 2, LH and FSH were checked at the next menstrual cycle day 2, and HMG and IVF-ET were administrated. The number of oocytes retrieved, oocytes fertilized, embryos transferred, embryos frozen, pregnancy rates, ampules of HMG and cost of the drugs were recorded. The comparison of means was performed using a two-sample unpaired t-test. Results: There were no statistically significant differences between the two groups in number of oocytes retrieved, oocytes fertilized, embryos transferred, embryos frozen, pregnancy rates and concentrations of E 2, LH and FSH. However, the cost of the drugs and ampules of HMG reduced significantly when compared with the regular dosage group. Conclusion: The reduced dose of GnRHa is still an effective and safe way in COH.