使用GnRHantagonis用於卵巢誘導破卵當期植入懷孕率&活產率較低

使用GnRHantagonist(腦下垂體拮抗劑)取代hCG用於卵巢誘導破卵

主要缺點: 當期植入(fresh ET)懷孕率&活產率較低

若改採冷凍胚胎下週期再植入懷孕率&活產率無明顯差異

GnRHantagonist 造成子宮內膜雌激素&黃體接受體表現下降

GnRHantagonist 造成子宮內膜雌激素ER alpha&黃體接受體PR表現下降

This study has shown that under the effect of a GnRH antagonist and rFSH with luteal phase progesterone supplementation, there is a significant down-regulation of PR in the surface epithelium. 


http://humrep.oxfordjournals.org/content/22/11/2981.full

於取卵後D5-7施打3天GnRHantagonist可改善OHSS

於取卵後D5-7施打3天GnRHantagonist可改善卵巢過度刺激OHSS

OHSS造成血液濃稠, MCV>45, WBC>15000, 卵巢>10cm,


http://humrep.oxfordjournals.org/content/22/5/1348.full
http://humrep.oxfordjournals.org/content/28/7/1929.full

GnRHantagonist療程不需事前使用pill

GnRHantagonist療程不需事前使用pill

使用pill 並不明顯提高懷孕率
反而提高COH劑量

http://www.ncbi.nlm.nih.gov/pubmed/18054003?dopt=Abstract

IVF提早或延後一日取卵並不明顯影響懷孕率

使用GnRHantagonist COH可提早或延後一日取卵並不明顯影響懷孕率

http://humrep.oxfordjournals.org/content/25/5/1219.full

GnRHantagonist不需提早在誘導排卵早期施打

提早施打GnRHantagonist (月經第2天)比常規施打GnRHantagonist (月經第7天)
臨床結果並無統計差異

http://www.ncbi.nlm.nih.gov/pubmed/24129613

COH期間LH上升後施打GnRHantagonist可達類似懷孕率

誘導排卵COHGnRHa長療程與GnRHantagonist比較
GnRHantagonist卵子數量略少於GnRHa長療程(7.9 and 9.6)

COH期間LH上升後可能伴隨著P4上升，
但立即施打GnRHantagonist可有效控制LH達到類似懷孕率

a rise in LH accompanied by a rise in progesterone concentration during ganirelix treatment was observed in only one subject. 

Prior to the start of ganirelix treatment, LH rises were observed in seven subjects, which were effectively suppressed by treatment with ganirelix. All seven women underwent embryo transfer and three of them achieved an ongoing pregnancy indicating that early LH rises do not affect the clinical outcome. 

http://humrep.oxfordjournals.org/content/16/4/644.full

使用GnRHantagonist並不會明顯壓抑黃體期之黃體素濃度

使用GnRHantagonist並不會明顯壓抑黃體期之黃體素P4濃度

使用GnRHantagonist會明顯壓抑黃體期之雌激素E2濃度

http://humrep.oxfordjournals.org/content/16/11/2258.full

高齡病患GnRHantagonist優於GnRHagonist短療程

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