高齡, 卵巢反應不佳，卵巢功能衰退之病患，使用GnRHantagonist取代GnRHagonist短療程可能可達到較佳之懷孕率
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3455641/pdf/10815_2004_Article_477339.pdf
Gonadotropin-releasing hormone (GnRH)-antagonist versus GnRH-agonist in
ovarian stimulation of poor responders undergoing IVF.
Source
IVF Unit, Department of Obstetrics and Gynecology, Hebrew University-Hadassah
Medical Center, Ein Kerem, PO Box 12000, 91120 Jerusalem, Israel.
Abstract
PURPOSE:
The objective of this study was to compare the efficacy of GnRH-antagonists
to GnRH-agonists in ovarian stimulation of poor responders undergoing IVF.
METHODS:
Retrospective analysis of our data revealed that 56 patients underwent
treatment with a GnRH-agonist according to the flare-up protocol. Patients
failing to achieve an ongoing pregnancy (n = 53) were subsequently treated in
the next cycle with a GnRH-antagonist according to the multiple-dose protocol.
Main outcome measures included the clinical pregnancy and implantation
rates.
RESULTS:
While ovulation induction characteristics and results did not differ between
the two protocols, the number of embryos transferred was significantly higher (P
= 0.046) in the GnRH-antagonist than in the GnRH-agonist stimulation protocol
(2.5 +/- 1.6 vs. 2.0 +/- 1.4, respectively). The clinical pregnancy and
implantation rates per transfer in the GnRH-antagonist group appeared higher
than in the GnRH-agonist, but did not differ statistically (26.1 and 10.7
compared with 12.2 and 5.9%, respectively). However, the ongoing pregnancy rate
per transfer was statistically significantly higher (P = 0.03) in the
GnRH-antagonist than in the GnRH-agonist group (23.9 vs. 7.3%,
respectively).
CONCLUSION:
Applying GnRH-antagonists to ovarian stimulation protocols may offer new hope
for IVF poor responder patients. However, further controlled randomized
prospective studies with larger sample sizes are required to establish these
results.
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