黄体期使用促性腺激素释放激素激动剂的效果评价

由于控制性超促排卵(COH)过程中超剂量雌、孕激素的生成以及垂体降调节药物的使用,经常出现黄体功能不全,需要常规进行黄体支持,常见的黄体支持方案包括使用人绒毛膜促性激素(hCG)及补充雌孕激素等。在近些年,多项研究表明促性腺激素释放激素激动剂(GnRH-a)在黄体支持中有很多积极方面,可以改善临床结局。其主要机制尚不清楚,可能与刺激黄体分泌雌、孕激素,提高子宫内膜容受性,提高胚胎发育潜能,促进滋养细胞分泌hCG相关。GnRHa进行黄体支持的机制及用法用量还有待进一步探究。

Current progress on gonadotropin-releasing hormone agonist for luteal phase support

Luteal-phase deficiency is a common problem resulting from supraphysiological steroid hormone levels together with the suppressed luteinizing hormone (LH) levels by both gonadotropin-releasing hormone agonist (GrnRH-a) and gonadotropin-releasing hormone antagonist (GnRH-A) administration during controlled ovarian hyperstimulation (COH) cycles.Therefore,luteal phase support is a common practice in IVF treatment.Most of these regimens involve the administration of human chorionic gonadotropin (hCG),estradiol (E2) and progesterone (P).Some recent data,however,have suggested a beneficial effect of GnRH-a administered in the luteal phase on assisted reproductive technique (ART) outcomes.The exactly mechanisms of actions and the ideal dose,administration route,and time interval of GnRH-a administration in the luteal phase support remain largely undetermined.