2012年7月3日

誘導排卵晚期可施打低劑量HCG 200 iu/day

誘導排卵晚期可考慮施打低劑量之HCG (200 iu/day)
可減少FSH劑量,提高卵泡之成熟度,並不會提早黃體化‧



Efficacy of low-dose human chorionic gonadotropin alone to complete controlled ovarian stimulation
Author(s): Filicori, M (Filicori, M); Cognigni, GE (Cognigni, GE); Gamberini, E (Gamberini, E); Parmegiani, L (Parmegiani, L); Troilo, E (Troilo, E)Roset, B (Roset, B)
Source: FERTILITY AND STERILITY  Volume: 84   Issue: 2   Pages: 394-401   DOI: 10.1016/j.fertnstert.2005.02.036   Published: AUG 2005
Times Cited: 42 (from Web of Science)
Cited References: 35      
Abstract: Objective: To prove that low-dose hCG alone can be clinically used to replace FSH-containing gonadotropins to complete controlled ovarian hyperstimulation (COH).

Design: Controlled, prospective, randomized study.

Setting; Academic center.

Patient(s): Infertile patients who are candidates for assisted reproduction.

Intervention(s): Patients received [1] recombinant FSH or hMG throughout COH (group A); [2] ovarian priming with recombinant FSH/hMG followed by low-dose hCG (200 IU/day) alone (group B).

Main Outcome Measure(s): Medication consumption; daily serum and follicular fluid (FF) measurements of LH, FSH, hCG, E-2, P, T, and androstenedione (A); number and size of follicles; intracytoplasmic sperm injection (ICSI) outcome.

Result(s): In group B: [1] duration and dose of recombinant FSH/hMG administration were reduced; [2] preovulatory serum hCG, E-2, and T were higher, whereas FSH was lower; [3] FF hCG, E-2, T levels, and E-2/T, E-2/A, and E-2/P ratios were higher, whereas A was lower; [4] small but not large preovulatory follicles were reduced; [5] fertilization rates were higher; and [6] serum and FF P levels, and ICSI outcome did not differ.

Conclusion(s): low-dose hCG alone in the late COH stages: [1] reduced recombinant FSH/hMG consumption whereas ICSI outcome was comparable to traditional COH regimens; [2] stimulated follicle growth and maturation independent of FSH administration; [3] was associated with a reduced number of small preovulatory follicles; [4] did not cause premature luteinization; [5] resulted in a more estrogenic intrafollicular environment.

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