IVF-ET中促性腺激素释放激素激动剂的超促排卵应用与剂量研究

促性腺激素释放激素激动剂(GnRH-a)是体外受精-胚胎移植(IVF-ET)技术中重要用药。GnRH-a与GnRH受体结合后,早期"突发"作用可刺激垂体促性腺激素急剧释放,持续应用后使垂体受抑制,内源性促性腺激素(Gn)水平下降,即所谓的降调节作用。利用这种生物学特性,GnRH-a联合Gn超促排卵可预防早发黄体生成素(LH)峰,避免卵泡过早黄素化。另外,GnRH-a代替人绒毛膜促性腺激素诱发排卵可降低卵巢过度刺激综合征(OHSS)发生率。探索既能有效抑制LH峰,又不使垂体过度抑制的GnRH-a有效低剂量对于超促排卵有重要意义。

Gonadotropin-releasing Hormone Agonist for Controlled Ovarian Hyperstimulation and Dose-finding Study in In Vitro Fertilization-Embryo Transfer

Gonadotropin-releasing hormone agonist(GnRH-a) is one of the most effective drugs used for controlled ovarian hyperstimulation(COH) in in vitro fertilization-embryo transfer(IVF-ET).The early "flare up" of GnRH-a can stimulate the sharp release of endogenous gonadotropins.Continuous administration of GnRH-a caused reversibly block of pituitary function and low level of endogenous gonadotropin,which is the so-called down-regulation.Therefore,GnRH agonist protocol with exogenous gonadotropins can prevent a luteinizing hormone surge,premature oocyte maturation and luteinization.In addition,GnRH-a triggering which can take the place of hCG triggering leads to a significant reduction of OHSS rate.To explore the effective low dose of GnRH-a which can prevent a LH surge without excessive pituitary desensitization has a critical role for COH.