|本期目录/Table of Contents|

[1]刘 娇,罗海宁,韩 莹,等.比较GnRH激动剂长方案与GnRH拮抗剂方案对LH/FSH比值大于等于2的多囊卵巢综合征患者临床结局影响[J].天津医科大学学报,2019,25(04):382-384390.
 LIU Jiao,LUO Hai-ning,HAN Ying,et al.Effects of different GnRH-analogue on polycystic ovarian syndrome with LH/FSH ratioof 2 or higher[J].Journal of Tianjin Medical University,2019,25(04):382-384390.
点击复制

比较GnRH激动剂长方案与GnRH拮抗剂方案对LH/FSH比值大于等于2的多囊卵巢综合征患者临床结局影响(PDF)
分享到:

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
25卷
期数:
2019年04期
页码:
382-384390
栏目:
临床医学
出版日期:
2019-07-20

文章信息/Info

Title:
Effects of different GnRH-analogue on polycystic ovarian syndrome with LH/FSH ratioof 2 or higher
文章编号:
1006-8147(2019)04-0382-03
作者:
刘 娇1罗海宁2韩 莹2曹 颖1张云山2
(1.天津医科大学研究生院,天津300070; 2.天津市中心妇产科医院生殖医学中心,天津300100)
Author(s):
LIU Jiao1 LUO Hai-ning2 HAN Ying2 CAO Ying1 ZHANG Run-shan2
(1. Graduate School, Tianjin Medical University, Tianjin 300070, China; 2. Reproductive Medicine Cencer, Tianjin Central Hospital of obstetrics and Gynecology, Tianjin, 300100, China)
关键词:
多囊卵巢综合征LH/FSHGnRH拮抗剂方案GnRH激动剂长方案体外受精-胚胎移植
Keywords:
PCOSLH/FSHGnRH antagonist protocolsGnRH agonist long protocols in vitro fertilization and embryo transfer
分类号:
R711.6
DOI:
-
文献标志码:
A
摘要:
目的:探讨促性腺激素释放激素(GnRH)激动剂长方案与GnRH拮抗剂方案对LH/FSH比值大于等于2的多囊卵巢综合征( PCOS)患者胎质量影响及助孕结局的差别。方法:回顾性分析本中心多囊卵巢综合征患者行体外受精-胚胎移植(IVF-ET),将月经第3天LH/FSH比值为2设为临界值分为比值升高组(58个周期)和比值未升高组(248个周期),分析比较两组基础临床资料,再分别根据不同促排卵方案分为GnRH激动剂长方案与GnRH拮抗剂方案组,根据LH/FSH的比值不同探讨不同促排卵方案对PCOS患者胚胎质量及妊娠结局的影响。结果:首次分组,LH/FSH≥2组Gn总量少于LH/FSH<2组(P<0.05),胚胎质量及临床结局无统计学差异(P>0.05);再次分组,在LH/FSH≥2前提下应用GnRH拮抗剂方案组促性腺激素(Gn)总量、Gn总天数少于GnRH激动剂长方案组(P<0.05),获卵数、正常受精数、正常卵裂数、优胚数均优于GnRH激动剂长方案组(P<0.05)。结论:PCOS患者中月经第3天LH/FSH比值以2为临界值可能对胚胎质量及临床结局无显著影响,LH/FSH临界值≥2的PCOS患者应用GnRH拮抗剂方案临床结局明显优于GnRH激动剂长方案。
Abstract:
Objective: To explore the effect of different GnRH-analogue on the quality of embryos and the outcome of pregnancy in patients with polycystic ovary syndrome (PCOS) with LH/FSH ratio of 2 or higher. Methods: With the PCOS patients day-3 LH/FSH ratio of 2 as the critical value, the data of 58 cycles which ratio greater than or equal to 2 and the data of 248 cycles which ratio less than 2 were analyzed retrospectively. And then the subjects were again divided into GnRH antagonist protocol group and GnRH agonist protocol group according to different GnRH-analogue. In the light of the ratio of LH/FSH,the relationship between different GnRH-analogues and clinical outcome was discussed. Results:The total number of Gn in LH/FSH≥2 group was less than that in LH/FSH<2 group (P<0.05). There was no significant differences in embryo quality and clinical outcome; the length of stimulation and the dose of gonadotropin were significantly less in GnRH antagonist group than in GnRH agonist long protocol group under the premise of LH/FSH≥2(P<0.05); the number of retrieval oocytes, normal-fertilized oocytes,normal-cleavage oocytes and high quality embryos were better than the GnRH agonist long protocol group (P>0.05). Conclusion: The day-3 LH/FSH ratio of PCOS patients with 2 as the critical value may not have significant effects on embryo quality and clinical outcomes, and the clinical outcomes of LH/FSH≥2 in patients with polycystic ovary syndrome GnRH antagonist scheme significantly outperforms the GnRH agonist long protocol.

参考文献/References:


[1] Tanguturi S C, Nagarakanti S. Polycystic ovary syndrome and periodontal disease: Underlying links- A review[J]. Indian J Endocrinol Metab, 2018,22(2):267
[2] Taymor M L. The regulation of follicle growth: some clinical implications in reproductive endocrinology[J]. Fertil Steril, 1996,65(2):235
[3] Shoham Z. The clinical therapeutic window for luteinizing hormone in controlled ovarian stimulation[J]. Fertil Steril, 2002,77(6):1170
[4] Mendoza C, Ruiz-Requena E, Ortega E, et al. Follicular fluid markers of oocyte developmental potential[J]. Hum Reprod, 2002, 17(4):1017
[5] Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome[J]. Fertil Steril, 2004, 81(1):19
[6] Gomez-Palomares J L, Acevedo-Martin B, Andres L, et al. LH improves early follicular recruitment in women over 38 years old[J]. Reprod Biomed Online, 2005,11(4):409
[7] Al-Inany H G, Youssef M A, Ayeleke R O, et al. Gonadotrophin-releasing hormone antagonists for assisted reproductive technology[J]. Cochrane Database Syst Rev, 2016,4:D1750
[8] Choi M H, Lee S H, Kim H O, et al. Comparison of assisted reproductive technology outcomes in infertile women with polycystic ovary syndrome: In vitro maturation, GnRH agonist, and GnRH antagonist cycles[J]. Clin Exp Reprod Med, 2012,39(4):166
[9] Orvieto R, Meltcer S, Liberty G, et al. Does day-3 LH/FSH ratio influence in vitro fertilization outcome in PCOS patients undergoing controlled ovarian hyperstimulation with different GnRH-analogue[J]. Gynecol Endocrinol, 2012,28(6):422
[10] Lin H, Li Y, Li L, et al. Is a GnRH antagonist protocol better in PCOS patients? A meta-analysis of RCTs[J]. PLoS One, 2014,9(3):e91796
[11] Sagnella F, Apa R, Guido M, et al. Suppression and recovery of gonadotropin and steroid secretion by a gonadotropin-releasing hormone receptor antagonist in healthy women with normal ovulation versus women with polycystic ovary syndrome in the early follicular phase[J]. Fertil Steril, 2009,91(5):1857

相似文献/References:

[1]李 江,王 刚.性激素结合球蛋白在多囊卵巢综合征患者中的变化及与其他指标的关系[J].天津医科大学学报,2016,22(04):325.
 LI Jiang,WANG Gang.Changes of SHBG in patients with polycystic ovary syndrome and their relationship with other indicators[J].Journal of Tianjin Medical University,2016,22(04):325.
[2]李英,张学军.miR-93在多囊卵巢综合征患者血清中的表达及临床意义[J].天津医科大学学报,2018,24(03):209.
 LI Ying,ZHANG Xue-jun.Expression and clinical significance of miR-93 in the serum of patients with polycystic ovary syndrome[J].Journal of Tianjin Medical University,2018,24(04):209.
[3]邹怡欣,时雨杰综 述,刘 煜,等.多囊卵巢综合征与生物钟的研究进展[J].天津医科大学学报,2020,26(01):91.
[4]刘贝贝,刘伟靓,杜曲晓,等.血清miR-27a水平与多囊卵巢综合征及其临床特征的相关性[J].天津医科大学学报,2021,27(02):117.
 LIU Bei-bei,LIU Wei-liang,DU Qu-xiao,et al.Correlation of serum miR-27a level with polycystic ovarian syndrome and its clinical characteristics[J].Journal of Tianjin Medical University,2021,27(04):117.
[5]董蕾,史天云.多囊卵巢综合征外周血中miR-132和SMAD4的表达对颗粒细胞增殖和凋亡的影响[J].天津医科大学学报,2022,28(05):525.
 DONG Lei,SHI Tian-yun.Effects of miR-132 and SMAD4 expression in peripheral blood of polycystic ovary syndrome on the proliferation and apoptosis of granulosa cells[J].Journal of Tianjin Medical University,2022,28(04):525.
[6]孙奎奎,杨微微,王文靖,等.多囊卵巢综合征关键基因的筛选及其与疾病进展和预后的相关性分析[J].天津医科大学学报,2023,29(06):609.
 SUN Kui-kui,YANG Wei-wei,WANG Wen-jing,et al.Screening of key genes in polycystic ovary syndrome and analysis of their correlation with disease progression and prognosis[J].Journal of Tianjin Medical University,2023,29(04):609.

备注/Memo

备注/Memo:
作者简介 刘娇(1986-),女,主治医师,硕士在读,研究方向:生殖医学;通信作者:张云山,E-mail:tjzys@hotmail.com。
更新日期/Last Update: 2019-08-28