نتایج بارداری بهروش لقاح خارج رحمی در تحریک با آگونیست آزاد کننده گنادوتروپین، گنادوتروپین جفتی انسان و یا گنادوتروپین جفتی انسان به همراه آگونیست آزادکننده گنادوتروپین در زنان نابارور؛ کارآزمایی بالینی تصادفی

Alamtaj Samsami, Sara Davoodi, Shaghayegh Moradi Alamdarloo, T. Poordast, Zahra Shiravani, Azade Morshedzadeh
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Abstract

Introduction: Human chorionic gonadotropin for the final maturation of eggs in the In-vitro fertilization cycle was associated with the possibility of a negative effect on endometrial acceptance, fetal quality and ovarian hyper stimulation syndrome. Replacing it with a gonadotropin-releasing hormone agonist to trigger final ovulation is expected to reduce these effects. Therefore, this study was performed with aim to evaluate the outcome of triggering in in vitro fertilization with antagonist protocol by gonadotropin-releasing hormone agonist, human chorionic gonadotropin simultaneously with human gonadotropin-releasing hormone agonist and human chorionic gonadotropin.  Methods: In this randomized clinical trial study conducted in 2015 and 2016, women were divided into three random groups after preparing the follicles for triggering and ovum retrieval. One group received 0.2 mg of dipherline, the second group received 10,000 units of human chorionic gonadotropin and the other group received 0.2 mg of dipherline along with 1500 units of human chorionic gonadotropin. The number and quality of eggs and embryos were the outcomes of the study. Data were analyzed by SPSS software (version 17) and Leven tests and one-way analysis of variance. P < 0.05 was considered statistically significant.  Results: The number of retrieved oocytes in the group receiving gonadotropin-releasing agonist was significantly higher than the other groups (p = 0.001). More embryos were produced in the gonadotropin-releasing hormone agonist group compared to the other two groups (p = 0.009). However, the number of high quality embryos produced in the groups was similar. Conclusion: The onset of final oocyte maturation with gonadotropin-releasing hormone agonist significantly increases the number of retrieved oocytes and obtained embryos. However, dual stimulation using low-dose human chorionic gonadotropin (IU1500) and gonadotropin-releasing hormone agonist did not alter quality of embryo compared to the standard dose of human chorionic gonadotropin (IU10000).
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人绒毛膜促性腺激素用于体外受精周期中卵子的最终成熟,可能对子宫内膜接受、胎儿质量和卵巢过度刺激综合征产生负面影响。用促性腺激素释放激素激动剂替代它来触发最终排卵,有望减少这些影响。因此,本研究旨在评价促性腺激素释放激素激动剂、人绒毛膜促性腺激素与人促性腺激素释放激素激动剂和人绒毛膜促性腺激素同时使用拮抗剂方案触发体外受精的效果。方法:在2015年和2016年进行的随机临床试验研究中,女性在准备好卵泡触发和取卵后随机分为三组。一组注射0.2毫克的迪弗兰,第二组注射10000单位的人绒毛膜促性腺激素,另一组注射0.2毫克的迪弗兰,同时注射1500单位的人绒毛膜促性腺激素。卵子和胚胎的数量和质量是研究的结果。数据采用SPSS软件(version 17)、Leven检验和单因素方差分析。P < 0.05为差异有统计学意义。结果:促性腺激素释放激动剂组取卵数显著高于其他组(p = 0.001)。与其他两组相比,促性腺激素释放激素激动剂组产生的胚胎更多(p = 0.009)。然而,两组中产生的高质量胚胎数量是相似的。结论:使用促性腺激素释放激素激动剂使卵母细胞最终成熟,可显著增加获得的卵母细胞和胚胎的数量。然而,与标准剂量的人绒毛膜促性腺激素(IU10000)相比,使用低剂量的人绒毛膜促性腺激素(IU1500)和促性腺激素释放激素激动剂的双重刺激没有改变胚胎质量。
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