经过修改的灵活的GnRH抗剂协议,使用抗剂早期停止和淋巴激素降级方法,改善新生周期的活产率:一种随机对照试验
Bei Xu1, Dirk Geerts2, Jiaying Yuan1
1Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
Human reproduction (Oxford, England)
|June 28, 2024
概括
经过修改的GnRH抗剂协议改善了新鲜单个胚胎移植周期中的活产率. 这种方法涉及淋巴激素降低和hCG日抗体停止,为正常卵巢反应的女性提供了更好的结果.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精 (IVF)
背景情况:
- 目前的GnRH对抗剂方案缺乏共识,新周期显示的结果比GnRH对抗剂方案差.
- 在这些协议中,子宫内膜受体是影响怀孕成功的关键因素.
研究的目的:
- 评估修改后的GnRH对抗剂方案,使用淋巴激素降级方法和hCG一天的对抗剂停止,是否可以改善正常响应者的新选单胚胎移植 (eSET) 周期中的怀孕结果.
主要方法:
- 一项开放的随机对照试验 (RCT) 涉及546名患者,将修改后的GnRH抗剂方案与传统方案进行比较.
- 主要结局是每次新生eSET周期的活产率 (LBR),次要结局包括植入,怀孕和流产率.
主要成果:
- 修改后的对抗剂协议在意向治疗 (38.1%对27.5%) 和每条协议 (48.6%对36.8%) 分析中显著增加了每次新 eSET 周期的 LBR.
- 在修改协议组 (P <0.05) 中观察到更高的植入率,临床怀孕率和持续怀孕率.
- 两组之间在卵细胞产量,胚胎质量或OHSS发生率方面没有发现显著差异.
结论:
- 修改后的GnRH对抗剂协议,具有Gn降级和早期对抗剂停止,有效地增强LBR在正常响应者的新 eSET循环中.
- 这一战略代表了提高特定患者群体体体外受精试管婴儿成功率的有希望的进展.
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