GnRHantagonist試管療程前服用避孕藥並不明顯提高取卵數

GnRHantagonist之COH療程前一月服用避孕藥以達COH卵子同步化

似乎是沒必要(並不明顯提高取卵數)，

研究顯示卵子取得並沒有較多，反而造成排卵針施打較多‧

Fertil Steril. 2012 Jun;97(6):1359-64.e1. Epub 2012 Mar 28.

Pretreatment with estrogen does not affect IVF-ICSI cycle outcome compared with no pretreatment in GnRH antagonist protocol: a prospective randomized trial.

Cédrin-Durnerin I, Guivarc'h-Levêque A, Hugues JN; Groupe d'Etude en Médecine et Endocrinologie de la Reproduction.

Collaborators (6)

Parneix I, Vasseur C, Bettina Bständig P, Lesourd F, Marcollin G, Colombel A.

Source

Service de Médecine de la Reproduction, Hôpital Jean Verdier, Assistance Publique-Hôpitaux de Paris, Université Paris XIII, Bondy, France. isabelle.cedrin-durnerin@jvr.ap-hop-paris.fr

Abstract

OBJECTIVE:

To assess effects of estrogen pretreatment in GnRH antagonist protocol.

DESIGN:

Prospective, randomized multicenter study.

SETTING:

Ten private or university-based centers.

PATIENT(S):

A total of 472 patients undergoing IVF/ICSI.

INTERVENTION(S):

Randomization by sealed envelopes to receive 17β-estradiol (4 mg/d) or no pretreatment before daily recombinant FSH administration started on the first day of estrogen discontinuation or on cycle day 2 in nonpretreated women.

MAIN OUTCOME MEASURE(S):

The primary outcome measure was the number of retrieved oocytes. Secondary efficacy variables included total FSH dose, cycle duration, and outcome.

RESULT(S):

The mean numbers of retrieved oocytes (10.9 ± 5.7 vs. 10.2 ± 5.6) and obtained embryos (5.5 ± 3.7 vs. 4.8 ± 3.7) were not significantly different between women allocated to estrogen pretreatment (n = 238) and no pretreatment (n = 234). Total FSH amount (1,557 ± 408 vs. 1,389 ± 347 IU) and stimulation duration (10.8 ± 1.4 vs. 10.0 ± 1.5 days) were slightly but significantly increased in pretreated patients. Positive pregnancy tests, ultrasound pregnancy rate, and delivery rate per cycle were similar (36%, 33%, and 26.6%, respectively, vs. 38.2%, 35.4%, and 30%).

CONCLUSION(S):

These data confirm that estrogen pretreatment is associated with requirement of higher FSH doses and longer duration of stimulation without any significant increase in the number of retrieved oocytes. However, estrogen does not affect cycle outcome and therefore might be used in clinical practice for programming IVF retrievals during working days.