GnRH激动剂在一次试管婴儿周期后改善了CLBR:一种倾向性得分匹配和分子机制研究
Xueqin Cai1, Hui Ding1, Yi Liu1
1Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, 430022.
Reproduction & fertility
|November 24, 2025
概括
在试管婴儿患者中,GnRH抗体协议导致了较高的累积活产率,而不是与GnRH抗体协议相比. 反对者协议可能会降低子宫内膜受容性,影响活产率.
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:
- 在试管婴儿中,激素释放激素 (GnRH) 抗剂协议的有效性仍在争论中.
- 不一致的结论和有限的子组分析需要进一步的临床指导.
研究的目的:
- 为了比较 GnRH 激动剂和对抗剂协议之间的累积活产率 (CLBR).
- 为在试管婴儿治疗中选择适当的GnRH协议提供临床参考.
主要方法:
- 对1845名接受试管婴儿/ICSI治疗的不孕症患者进行了回顾性队列研究.
- 倾向性得分匹配 (PSM) 来控制人口特征.
- 对于CLBR分析和评估子宫内膜受体性标记物的多变量逻辑回归.
主要成果:
- 比起 GnRH 抗剂,GnRH 抗剂的CLBR (81.54%与73.07%) 显著高于GnRH 抗剂的CLBR.
- 此外,GnRH激动剂还显示出每次新鲜胚胎移植的临床妊娠率 (CPR) 和活产率 (LBR) 优异.
- GnRH对抗剂通过阻碍介质细胞-上皮细胞过渡 (MET) 和决定化,对子宫内膜受容性产生负面影响.
结论:
- 与GnRH对抗剂协议相比,GnRH对抗剂协议与优越的活产结果有关.
- 卵巢刺激方案,患者年龄和子宫内膜厚度是影响CLBR的独立因素.
- GnRH对抗剂协议可能会损害子宫内膜受容性,可能导致较低的LBR.
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