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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。
OBJECTIVE: To compare the hypofractionation effects of progestin agonist ararelin and short-acting triptorelin over a long-term regimen of ovulation induction in vitro fertilization and embryo transfer (IVF-ET). METHODS: A total of 122 IVF-ET patients from November 2005 to December 2008 were retrospectively selected. The patients were enrolled at the age of 24-39 years. Secondary infertility and basal antral follicles at both sides In 10 to 20; exclusive Polycystic ovary syndrome; IVF indications for pelvic fallopian tube factors. Among them, the ararelin (ararelin group) was used in 78 and the short-acting triptorelin (triptorelin) in 44. The effect of down-regulation and the clinical outcome of IVF-ET were analyzed and compared. Results: No premature LH peak and early spontaneous ovulation occurred in both alarelin and triptorelin groups. The average amount of gonadotropin (Gn) and days, the number of oocytes retrieved, the percentage of oocytes retrieved, No significant difference was found between normal fertilization rate, abnormal fertilization rate, cleavage rate, high quality embryo rate, embryo transfer rate, embryo implantation rate, clinical pregnancy rate and early abortion rate (P> 0.05) Severe ovarian hyperstimulation syndrome, but triptorelin group cycle cancellation rate was higher than the arelinrelin group, there was a significant difference (P <0.05). CONCLUSIONS: In the long-term hyperstimulation of IVF-ET, propranolol has the same down-regulation and clinical effects as short-acting triptorelin.