摘要
目的研究促性腺激素释放激素(gonadotropin releasing hormone,GnRH)拮抗剂有效抑制促排卵过程提前出现的黄体生成素(luteinization hormone,LH)峰值,降低GnRH拮抗剂用量,观察其对卵泡提前黄素化的治疗效果。方法选择我院2010年10月～2012年5月出现2次或以上卵泡提前黄素化的患者15例,分成两个周期促排卵治疗行夫精人工授精,A组(15个周期)进行常规促排卵治疗,B组(15个周期)加用西曲瑞克0.125 mg/d促排卵治疗,观察治疗结局。结果 A组15个周期,发生卵泡提前黄素化13个周期,B组15个周期,发生卵泡提前黄素化1个周期,差异有高度统计学意义(P<0.01);A组人绒毛膜促性腺激素(HCG)日黄体生成素(LH)(12.2±8.6)IU/L,B组(4.0±4.8)IU/L,差异有统计学意义(P=0.008);A组孕酮(P)(2.7±1.9)ng/mL,B组(0.9±1.8)ng/mL,差异有统计学意义(P=0.012);A组使用人绝经促性腺素(HMG)用量(750.0±138.8)IU,B组(907.5±208.4)IU,差异有统计学意义(P=0.003);A组HCG日雌激素(E2)(607.4±315.3)pg/mL,B组E2(1264.0±763.4)pg/mL,差异有统计学意义(P=0.006);A组优势卵泡(2.0±1.1)个,B组(3.2±1.5)个,差异有统计学意义(P=0.044);A组卵泡最大直径(17.5±0.8)mm,B组(18.1±0.7)mm,差异有统计学意义(P=0.013);A组子宫内膜厚度(10.1±1.5)mm,B组(11.1±1.6)mm,差异无统计学意义(P=0.062)。结论促排卵治疗过程中加入西曲瑞克0.125 mg/d可以有效减少提前出现LH升高和卵泡提前黄素化发生率,促排卵后成熟卵泡增多,卵泡直径增加,子宫内膜没有出现显著变化。
Objective To explore low doses of ganodotropin releasing hormone（GnRH） antagonist in inhibiting the follicle premature luteinization,to reduce the dosage of GnRH antagonist and to observe the therapeutic effect of follicle premature luteinization.Methods 15 patients with recurrent follicle premature luteinization at least 2 times in our hospital from October 2010 to May 2012 were recruited to the artificial insemination by husband,every patient was treated with two stimulation cycles.All the patients were divided into A group and B group,patients in group A（15 cycles） were stimulated with conventional HMG promoting ovulation treatment;patients in group B（15 cycles） were stimulated with HMG＋Cetrorelix 0.125 mg/d,after the stimulation,treatment outcome in both groups were observed.Results 13 cycles of follicle premature luteinization were found in 15 cycles in group A,1 cycles of follicle premature luteinization were found in 15 cycles in group B,the difference was statistically significant（P〈0.01）;Luteinization hormone（LH） on the day of HCG injection was（12.2±8.6） IU/L in group A and（4.0±4.8） IU/L in group B,the difference was statistically significant（P = 0.008）;Progesterone（P） was（2.7±1.9）ng/mL in group A and（0.9±1.8） ng/mL in group B,the difference was statistically significant（P = 0.012）;The HMG amounts was（750.0±138.8） IU in group A and（907.5±208.4） IU in group B,the difference was statistically significant（P = 0.003）;the dominant follicle number was（2.0±1.1） in group A and（3.2±1.5） in group B,the difference was statistically significant（P = 0.044）;the average diameter of follicle was（17.5±0.8） mm in group A and（18.1±0.7） mm in group B,the difference was statistically significant（P = 0.013）.The endometrium thickness was（10.1±1.5） mm in group A and（11.1±1.6） mm in group B,the difference was not statistically significant（P = 0.062）.Conclusion Cetrorelix with 0.125 mg per day is effectively in inhibiting follicle premature luteinization in the follicle stimulation protocol.Cetrorelix increases mature follicles and has no effect on endometrium thickness.
出处
《中国医药导报》
CAS
2013年第3期61-63,共3页
China Medical Herald
基金
广东省医学科学技术研究基金项目(项目编号:A2011710)
关键词
促性腺激素释放激素拮抗剂
黄素化
卵泡
促排卵治疗
Gonadotropin releasing hormone antagonist
Luteinization
Ovarian follicle
Ovarian stimulation
