克罗米芬与GnRH拮抗剂在控制性超促排卵中抑制LH峰效果的比较

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目的:探讨克罗米芬(CC)与GnRH拮抗剂(GnRH-A)在控制性超促排卵(COH)中对黄体生成素(LH)峰抑制效果的比较。方法:对应用CC后置方案和拮抗剂方案的181个周期的资料进行回顾性分析。其中应用CC抑制LH峰方案65例(CC组),应用GnRH-A(思则凯组)抑制LH峰方案116例。比较2种药物对LH峰的抑制作用、Gn用量、获卵数、可移植胚胎数、优质胚胎数、受精率等。结果:hCG注射日LH值与加用CC或思则凯日LH值的差值[LH(d-)]具有统计学差异(1.30±5.12 IU/L vs-1.37±7.15 IU/L,P=0.004);Gn用量、获卵数、可移植胚胎数、优质胚胎数、受精率等CC组和思则凯组比较差异无统计学意义(P>0.05)。结论:CC与思则凯对早发LH峰均有一定抑制效果,但较CC相比其抑制早发LH峰效果可能更明显。 Objective: To investigate the inhibitory effect of clomiphene citrate (CC) and GnRH antagonist (GnRH-A) on luteinizing hormone (LH) peak in controlled hyperstimulation (COH). Methods: Retrospective analysis was performed on 181 cycles using the CC regimen and the antagonist regimen. Among them, 65 cases (CC group) with CC LH suppression were treated with CC and 116 cases with LH peak were treated with GnRH-A (SI group). The inhibitory effects of two drugs on LH peak, Gn dosage, number of oocytes retrieved, number of transferable embryos, number of high quality embryos and fertilization rate were compared. Results: There was a significant difference between the LH value on the day of injection of hCG and the value of added LH on LH or CC (1.30 ± 5.12 IU / L vs-1.37 ± 7.15 IU / L, P = 0.004). There was no significant difference in the amount of Gn, the number of oocytes retrieved, the number of transferable embryos, the number of high quality embryos and the fertilization rate between CC group and thinking group (P> 0.05). CONCLUSION: Both CC and SIK have some inhibitory effects on early LH peak, but they may be more effective than CC in inhibiting early LH peak.
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