長療程使用pill, GnRHa, E2  會造成卵巢基礎濾泡數量減少, 進而影響COH卵子取出數量
(影響度: pill>GnRHa>E2)

Fertil Steril. 2015 Dec 13. pii: S0015-0282(15)02117-2. doi: 10.1016/j.fertnstert.2015.11.033. [Epub ahead of print]

Impact of pituitary suppression on antral follicle count and oocyte recovery after ovarian stimulation.

Tran ND1, Aghajanova L2, Kao CN2, Cedars MI2, Rosen MP2.

Author information

Abstract

OBJECTIVE:

To investigate the potential influence of short-term pituitary suppression on antral follicle count (AFC) and correlate the AFC with the number of oocytes retrieved after ovarian stimulation.

DESIGN:

Retrospective study.

SETTING:

University fertility center.

PATIENT(S):

A total of 1,479 infertile patients.

INTERVENTION(S):

Patients had baseline AFC, when they were not on any medications known to cause pituitary suppression, and follow-up AFC (suppressed AFC) while on E2, GnRH agonist (GnRH-a), oral contraceptive (OC) pills, or OC pills/GnRH-a in preparation for ovarian stimulation, performed within 6 months of initial baseline AFC.

MAIN OUTCOME MEASURE(S):

The AFC at baseline, AFC during pituitary suppression, and the number of oocytes retrieved.

RESULT(S):

Although there was an average unadjusted decline of 0.4, 0.9, 2.2, and 3.0 in AFC while patients were on E2, GnRH-a, OC pills, and OC pills/GnRH-a, respectively, this decline was driven by age, baseline AFC, and the hormones used. Although baseline and suppressed AFC were found to be good predictors of the number of oocytes retrieved after ovarian stimulation, statistically, suppressed AFC was found to be a marginally better predictor.

CONCLUSION(S):

Short-term pituitary suppression has a negative impact on AFC. This decline in AFC may influence the number of oocytes retrieved, suggesting the suppressive impact of exogenous hormones on the biological capacity of the ovary during stimulation.