The effects of pituitary suppression with one-third depot of long-acting gonadotropin-releasing hormone(Gn RH) agonist in Gn RH agonist long protocol for in vitro fertilization(IVF)/intracytoplasmic sperm injectio...The effects of pituitary suppression with one-third depot of long-acting gonadotropin-releasing hormone(Gn RH) agonist in Gn RH agonist long protocol for in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI) were investigated. A retrospective cohort study was performed on 3186 cycles undergoing IVF/ICSI with Gn RH agonist long protocol in a university-affiliated infertility center. The pituitary was suppressed with depot triptorelin of 1.25 mg or 1.875 mg. There was no significant difference in live birth rate between 1.25 mg triptorelin group and 1.875 mg triptorelin group(41.2% vs. 43.7%). The mean luteinizing hormone(LH) level on follicle-stimulating hormone(FSH) starting day was significantly higher in 1.25 mg triptorelin group. The mean LH level on the day of human chorionic gonadotrophin(h CG) administration was slightly but statistically higher in 1.25 mg triptorelin group. There was no significant difference in the total FSH dose between the two groups. The number of retrieved oocytes was slightly but statistically less in 1.25 mg triptorelin group than in 1.875 mg triptorelin group(12.90±5.82 vs. 13.52±6.97). There was no significant difference in clinical pregnancy rate between the two groups(50.5% vs. 54.5%). It was suggested that one-third depot triptorelin can achieve satisfactory pituitary suppression and produce good live birth rates in a long protocol for IVF/ICSI.展开更多
基金supported by grants from Milstein Medical Asian American Partnership Foundation Fellowship Award in Reproductive Medicine,National Natural Science Foundation of China(No.81170574 and No.81401177)Guangdong Province Natural Science Foundation of China(No.2015A030313286)Nanfang Hospital High-level Project Matching Funds in 2012(No.G201206)and 2014(No.G2014005)
文摘The effects of pituitary suppression with one-third depot of long-acting gonadotropin-releasing hormone(Gn RH) agonist in Gn RH agonist long protocol for in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI) were investigated. A retrospective cohort study was performed on 3186 cycles undergoing IVF/ICSI with Gn RH agonist long protocol in a university-affiliated infertility center. The pituitary was suppressed with depot triptorelin of 1.25 mg or 1.875 mg. There was no significant difference in live birth rate between 1.25 mg triptorelin group and 1.875 mg triptorelin group(41.2% vs. 43.7%). The mean luteinizing hormone(LH) level on follicle-stimulating hormone(FSH) starting day was significantly higher in 1.25 mg triptorelin group. The mean LH level on the day of human chorionic gonadotrophin(h CG) administration was slightly but statistically higher in 1.25 mg triptorelin group. There was no significant difference in the total FSH dose between the two groups. The number of retrieved oocytes was slightly but statistically less in 1.25 mg triptorelin group than in 1.875 mg triptorelin group(12.90±5.82 vs. 13.52±6.97). There was no significant difference in clinical pregnancy rate between the two groups(50.5% vs. 54.5%). It was suggested that one-third depot triptorelin can achieve satisfactory pituitary suppression and produce good live birth rates in a long protocol for IVF/ICSI.
文摘目的:探讨拮抗剂方案取卵后48 h雌二醇(estradiol,E_(2))水平较取卵前24 h下降幅度对新鲜胚胎移植妊娠结局的影响。方法:回顾性分析2017年1月—2021年3月在南京医科大学附属妇产医院生殖医学中心采用拮抗剂方案超促排卵并行新鲜胚胎移植413个周期的临床资料,根据取卵后48 h较取卵前24 h E_(2)下降幅度按四分位数分为4组。A组:降低幅度范围在总体降低范围的0~25.0%;B组:25.1%~50.0%;C组:50.1%~75.0%;D组:75.1%~100.0%。比较各组促排卵情况、胚胎参数及妊娠结局,并通过Logistic回归分析E_(2)降低幅度与活产率的关系。结果:4组的促性腺激素(gonadotropins,Gn)总量、拮抗剂使用时间、活产率、种植率和临床妊娠率比较,差异均有统计学意义(均P<0.05)。A组活产率大于D组,B组活产率大于C组及D组,A组、B组种植率大于D组,差异均有统计学意义(均P<0.008 3)。校正组间差异因素后,A、B组的活产率均高于于D组(OR=2.079,95%CI:1.138~3.799,P=0.017;OR=2.187,95%CI:1.213~3.944,P=0.009)。结论:在拮抗剂方案中,取卵后48 h较取卵前24 h E_(2)降低幅度较大的患者新鲜胚胎移植的活产率低于变化较小的患者。