丙氨瑞林与曲普瑞林在长方案促排卵中的降调节效果比较

目的:比较促性腺激素激动剂丙氨瑞林与短效曲普瑞林在体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)治疗中长方案超促排卵的降调节效果。方法:回顾性选择2005年11月至2008年12月期间进行的122例IVF-ET患者作为研究对象,纳入条件为:患者年龄为24～39岁;继发不孕;两侧基础窦卵泡数在10～20个;排外多囊卵巢综合征;IVF指征为盆腔输卵管因素。其中,78例采用了丙氨瑞林(丙氨瑞林组),44例采用了短效曲普瑞林(曲普瑞林组)。分析和比较两组的降调节效果和IVF-ET的临床结果。结果:丙氨瑞林组和曲普瑞林组均未发生早发性LH峰和提前自发排卵,两组的平均促性腺激素(Gn)用量及天数、获卵数、获卵率、MⅡ卵子数、正常受精率、异常受精率、卵裂率、优质胚胎率、移植胚胎数、胚胎着床率、临床妊娠率及早期流产率均无显著性差异(P>0.05),两组均未发生重度卵巢过度刺激综合征,但曲普瑞林组的周期取消率高于丙氨瑞林组,有显著性差异(P<0.05)。结论:在IVF-ET的长方案超促排卵中,丙氨瑞林具有与短效曲普瑞林相同的降调节和临床治疗效果。

Comparison of Alarelin and Triptorelin in the long-protocol ovulation induction in in vitro fertilization and embryo transfer

Objective:To compare the pituitary down-regulatory effects of the two gonadotropin-releasing hormone agonists Alarelin and Triptorelin in the long protocol of ovulation induction in in vitro fertilization and embryo transfer (IVF-ET). Methods:We included in this study 122 patients aged 24-39 years treated by IVF-ET for secondary infertility,with 10-20 pre-antral follicles and obstruction of the fallopian tube. Seventy-eight of them received Alarelin,and the other 44 Triptorelin. Comparative analyses were made on the pituitary down-regulatory effects of the two gonadotropin-releasing hormone agonists and the clinical outcomes of IVF-ET.Results:No premature LH surge and ovulation,nor severe hyperovarian stimulation syndrome was found in either group. There were no significant differences between the two groups in the mean dose and duration of gonodatropin treatment,the numbers of oocytes retrieved,mature oocytes and top-quality embryos,and the rates of 2PN,multi-sperm fertilization,cleavage,embryo transfer,embryo implantation,clinical pregnancy and early miscarriage (P>0.05),but the rate of cancelled cycles was significantly higher in the Triptorelin than in the Alarelin group (P<0.05). Conclusion:Alarelin and Triptorelin can achieve similar pituitary down-regulatory effects and clinical outcomes in IVF-ET when used in the long protocol of ovulation induction.