促性腺激素释放激素(GnRH)激动剂的触发是有益还是有害?

Gynecologie Obstetrique & Fertilite Pub Date : 2016-07-01 DOI:10.1016/j.gyobfe.2016.05.013

M. Le Chatton , C. Wittemer , T. Schweitzer , F. Lestrade , J.-P. Ragage

{"title":"促性腺激素释放激素(GnRH)激动剂的触发是有益还是有害?","authors":"M. Le Chatton , C. Wittemer , T. Schweitzer , F. Lestrade , J.-P. Ragage","doi":"10.1016/j.gyobfe.2016.05.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>The undeniable asset of the antagonist protocols in in vitro fertilization is the decrease of the risks of ovarian hyperstimulation syndrome, by the use of a release by GnRH agonist. Nevertheless, questioning persist concerning the rates of clinical pregnancies, the oocyte quantity and the empty follicle syndrome. We thus studied these parameters in our center.</p></div><div><h3>Methods</h3><p>A retrospective study was realized from January 1st, 2013 till July 31st, 2015. The main objective was the evaluation of the rate of clinical pregnancies in antagonist protocol. A first group of 775 cycles have benefited from a release of the ovulation by HCG, while a second group of 204 cycles, by GnRH agonist. The secondary objectives were the oocyte quantity, the rate of ovarian hyperstimulation syndrome, and the rate of empty follicle syndrome.</p></div><div><h3>Results</h3><p>No statistically significant difference was found between both groups concerning the rates of clinical pregnancies, oocytes quantity, and the rate of empty follicle syndrome, whatever is the type of used release, in fresh embryo transfer. A syndrome of premature ovarian hyperstimulation syndrome was found at 7.9 % of the patients in the group 2 versus 2.3 % in the group 1, with a statistically significant difference (<em>P</em>  <0.05). At these patients, a strategy of frozen embryo transfer (“freeze all”) was proposed. The accumulated rates by pregnancy in both groups were not statistically different.</p></div><div><h3>Conclusion</h3><p>The release by GnRH agonist does not show inferiority in terms of clinical pregnancy, in comparison to HCG.</p></div>\",\"PeriodicalId\":55077,\"journal\":{\"name\":\"Gynecologie Obstetrique & Fertilite\",\"volume\":\"44 7\",\"pages\":\"Pages 403-409\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.gyobfe.2016.05.013\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gynecologie Obstetrique & Fertilite\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S129795891630162X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gynecologie Obstetrique & Fertilite","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S129795891630162X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

摘要

目的体外受精拮抗剂方案不可否认的优点是通过使用GnRH激动剂释放来降低卵巢过度刺激综合征的风险。然而，关于临床妊娠率、卵母细胞数量和空卵泡综合征的问题仍然存在。因此，我们在中心研究了这些参数。方法2013年1月1日至2015年7月31日进行回顾性研究。主要目的是评估拮抗剂方案的临床妊娠率。第一组775个周期受益于HCG释放排卵，而第二组204个周期受益于GnRH激动剂。次要指标为卵母细胞数量、卵巢过度刺激综合征发生率、空卵泡综合征发生率。结果两组在新鲜胚胎移植中临床妊娠率、卵母细胞数量、空卵泡综合征发生率，不论使用何种释放方式，差异均无统计学意义。2组患者出现卵巢过早过度刺激综合征的比例为7.9%，1组为2.3%，差异有统计学意义(P <0.05)。针对这些患者，提出了冷冻胚胎移植策略(“冷冻全部”)。两组妊娠累积率无统计学差异。结论GnRH激动剂的释放在临床妊娠方面不逊于HCG。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Le déclenchement par agonistes de la Gonadotropin releasing hormone (GnRH) est-il bénéfique ou délétère ?

Objectives

The undeniable asset of the antagonist protocols in in vitro fertilization is the decrease of the risks of ovarian hyperstimulation syndrome, by the use of a release by GnRH agonist. Nevertheless, questioning persist concerning the rates of clinical pregnancies, the oocyte quantity and the empty follicle syndrome. We thus studied these parameters in our center.

Methods

A retrospective study was realized from January 1st, 2013 till July 31st, 2015. The main objective was the evaluation of the rate of clinical pregnancies in antagonist protocol. A first group of 775 cycles have benefited from a release of the ovulation by HCG, while a second group of 204 cycles, by GnRH agonist. The secondary objectives were the oocyte quantity, the rate of ovarian hyperstimulation syndrome, and the rate of empty follicle syndrome.

Results

No statistically significant difference was found between both groups concerning the rates of clinical pregnancies, oocytes quantity, and the rate of empty follicle syndrome, whatever is the type of used release, in fresh embryo transfer. A syndrome of premature ovarian hyperstimulation syndrome was found at 7.9 % of the patients in the group 2 versus 2.3 % in the group 1, with a statistically significant difference (P < 0.05). At these patients, a strategy of frozen embryo transfer (“freeze all”) was proposed. The accumulated rates by pregnancy in both groups were not statistically different.