促性腺激素释放激素激动剂超短方案在超促排卵中的应用

目的：探讨促性腺激素释放激素激动剂（ＧｎＲＨ－ａ）超短方案在促排卵中的作用。方法：以采用克罗米芬联合人绒毛膜促性腺激素（ＣＣ／ｈＣＧ组，５０个周期、３１例），及克罗米芬联合人绝经期促性腺激素、绒毛膜促性腺激素（ＣＣ／ｈＭＧ／ｈＣＧ组，１６个周期、１６例）方案者为对照，对比ＧｎＲＨ－ａ超短方案联合人绝经期促性腺激素、绒毛膜促性腺激素方案者（ＧｎＲＨ－ａ超短方案／ｈＭＧ／ｈＣＧ组，１５个周期、１５例）ｈＣＧ注射日激素水平、优势卵泡个数、子宫内膜厚度、宫颈评分及妊娠率。ＧｎＲＨ－ａ超短方案／ｈＭＧ／ｈＣＧ组全部来自采用ＣＣ助孕失败或采用ＣＣ／ｈＭＧ／ｈＣＧ方案显示卵巢反应性差的患者。结果：ＣＣ／ｈＭＧ／ｈＣＧ组有３例（１８．８％）发生过早黄素化。ＧｎＲＨ－ａ超短方案／ｈＭＧ／ｈＣＧ组ｈＣＧ注射日血清黄体生成素（ＬＨ）水平明显低于对照组，其优势卵泡个数、子宫内膜厚度及宫颈评分都明显高于对照组，差异均具有显著性（Ｐ＜０．０５）。３组周期妊娠率相近。结论：ＧｎＲＨ－ａ超短方案／ｈＭＧ／ｈＣＧ方案为一种较好的促超排卵方案，对ＣＣ助孕失败及ＣＣ／ｈＭＧ／ｈＣＧ方案卵巢反应性差的患者仍有较好的效果。

Application of Ultra Short Gonadotropin Releasing Hormone Agonist Protocol in Controlled Ovarian Hyperstimulation

Objective: To study the effect of the ultra short protocol of gonadotropin releasing hormone agonist (GnRH a) combined with human menopausal gonadotropin (hMG) regimen for ovarian hyperstimulation. Methods: Setting clomiphene (CC)/human chorionic gonadotropin (hCG) (50 cycles, 31 patients) and CC/hMG/hCG regimens (16 cycles, 16 patients who had failed in CC/hCG) as control groups, the ultra short GnRH a/hMG/hCG regimen (15 cycles, 15 patients who had failed in CC alone or CC/hMG regimens) as study group, the number of leading follicles, endometrial thickness, cervical mucus scores and hormone levels on the day of hCG administration, and the pregnancy rates were compared among of these three groups. Results: There was no premature luteotropic hormone (LH) surge in the ultra short GnRH a/hMG/hCG regimen group while there were three cycles in the CC/hMG/hCG group. The LH and progesterone (P) levels of ultra short GnRH a/hMG group on the day of hCG administration were lower than those of CC alone and CC/hMG groups. There were more leading follicles, greater endometrial thickness and cervical mucus score in the ultra short GnRH a/hMG group than those in CC alone and CC/hMG groups. The pregnancy rates per cycles in the three groups were similar. Conclusion: The ultra short GnRH a/hMG regimen is a fairly good ovarian hyperstimulation regimen, especially for poor responders in CC alone or CC/hMG regimens.