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首页> 外文期刊>Taiwanese journal of obstetrics and gynecology >Comparisons of Different Dosages of GONADOTROPIN-RELEASING HORMONE (GnRH) Antagonist, Short-acting Form and Single
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Comparisons of Different Dosages of GONADOTROPIN-RELEASING HORMONE (GnRH) Antagonist, Short-acting Form and Single

机译：促性腺激素释放激素（GnRH）拮抗剂，短效型和单剂量不同剂量的比较

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Objective: Both gonadotropin-releasing hormone (GnRH) analogs and antagonists have been used for pituitary desensitization during controlled ovarian hyperstimulation (COH). We aimed to determine the minimum effective daily dose of GnRH antagonist in women undergoing COH. We also compared the efficiency of a GnRH antagonist and a GnRH agonist.Materials and Methods: Women undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer were divided into five groups: (1) cetrorelix 0.25 mg (n = 86); (2) cetrorelix 0.2 mg (n= 28); (3) cetrorelix 0.15mg (n = 30); (4) leuprolide acetate (LA) 0.5mg/day (n = 58); (5) single half-dose LA depot 1.88mg (n = 49). Cetrorelix was administered daily from menstrual day 8 until the day of human chorionic gonadotropin administration. LA or LA depot was started on day 21 of the previous menstrual cycle.Results: We observed lower gonadotropin (Gn) dosages, estradiol (E2) levels and reduced risk of ovarian hyperstimulation syndrome (OHSS) in the GnRH antagonist groups. A higher risk of luteinizing hormone (LH) surge was noted in cetrorelix 0.2 and 0.15 mg groups. Gn dosages (IU)/E2 levels (pg/mL) in each group were: (1) 1,949.4/ 1,191.1; (2) 1,869.6/1,010.8; (3) 1,856.7/1,023.6; (4) 2,184.5/1,323.6; and (5) 2,103.5/1,313.5, respectively. LH/OHSS risks were: (1) 3.5%/5.8%; (2) 7.1%/3.6%; (3) 13.3%/3.3%; (4) 3.496/8.6%; and (5) 2%/8.2%, respectively. Number of oocytes/embryos/grade I, II embryos were: (1) 9.4/7.9/5.8; (2) 7.5/4.2/3.6; (3) 6.3/4.1/3.1; (4) 12.3/ 8.9/6.6; and (5)11.8/8.4/6.1, respectively. There was no significant difference in terms of clinical outcomes between groups 1,4 and 5, except for higher abortion rates (AR) in group 1. Pregnancy rate (PR)/implantation rate (IR) ratios in groups 1, 4, and 5 were statistically higher than those in groups 2 and 3. Chemical PR/IR/AR were: (1) 30.2%/ S.9%/7%; (2) 21.4%/5.1%/7.1%; (3) 16.7%/4.1%/10%; (4) 32.8%/5.5%/8.6%; and (5) 30.6%/5.7%/8.2%, respectively. Conclusion: The lowest effective dosage of cetrorelix for pituitary desensitization during COH luteolysis is 0.25 mg, resulting in a comparable PR but a higher AR when compared with GnRH agonist.
机译：目的：促性腺激素释放激素（GnRH）类似物和拮抗剂均已用于控制性卵巢过度刺激（COH）期间垂体脱敏。我们旨在确定接受COH的女性中GnRH拮抗剂的最低每日有效剂量。材料和方法：进行体外受精/胞浆内精子注射和胚胎移植的妇女分为五组：（1）头孢曲瑞克0.25 mg（n = 86）; （2）cetrorelix 0.2 mg（n = 28）; （3）cetrorelix 0.15毫克（n = 30）; （4）醋酸亮丙瑞林（LA）0.5mg /天（n = 58）; （5）单个半剂量LA仓库1.88mg（n = 49）。从月经第8天到人类绒毛膜促性腺激素给药之日每天服用Cetrorelix。结果显示：在GnRH拮抗剂组中，我们观察到较低的促性腺激素（Gn）剂量，雌二醇（E2）水平并降低了卵巢过度刺激综合征（OHSS）的风险。在cetrorelix 0.2和0.15 mg组中，发现黄体激素（LH）升高的风险更高。每组的Gn剂量（IU）/ E2水平（pg / mL）为：（1）1,949.4 / 1,191.1; （2）1,869.6 / 1,010.8; （3）1,856.7 / 1,023.6; （4）2,184.5 / 1,323.6;和（5）2,103.5 / 1,313.5。 LH / OHSS风险为：（1）3.5％/ 5.8％; （2）7.1％/ 3.6％; （3）13.3％/ 3.3％; （4）3.496 / 8.6％;和（5）分别为2％/ 8.2％。卵母细胞/胚胎/ I，II级胚胎的数量为：（1）9.4 / 7.9 / 5.8; （2）7.5 / 4.2 / 3.6; （3）6.3 / 4.1 / 3.1; （4）12.3 / 8.9 / 6.6;和（5）11.8 / 8.4 / 6.1。在第1、4和5组之间，在临床结局方面没有显着差异，除了第1组的流产率（AR）高。第1、4和5组的怀孕率（PR）/着床率（IR）之比在统计学上高于第2组和第3组。化学PR / IR / AR为：（1）30.2％/ S.9％/ 7％; （2）21.4％/ 5.1％/ 7.1％; （3）16.7％/ 4.1％/ 10％; （4）32.8％/ 5.5％/ 8.6％;和（5）分别为30.6％/ 5.7％/ 8.2％。结论：头孢曲瑞克用于COH黄体溶解期间垂体脱敏的最低有效剂量为0.25 mg，与GnRH激动剂相比，可产生相当的PR，但AR较高。

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