The Trigger Effect Comparison Of GnRHa And HCG For The Treatment Of Infertile Patients With PCOS

Objectives To compare the effects of gonadotropin-releasing hormone agonist(Gn RHa) and man chorionic gonadotropin(HCG) in applying for the threatment of follicular maturation and ovulation in infertile patients with polycystic ovary syndrome(PCOS).Methods The prospective study was performed at Tangshan City maternal and child health hospital(Jan 2015 ~ De 2015). Based on the inclusion criteria, 122 patients with PCOS who receiving guidance intercourse after ovulation induction treatment and 103 patients with PCOS who receiving IUI after stimulate ovulation treatment were selected as subjects. Patients with PCOS receiving guidance intercourse after ovulation induction treatment by CC were randomly divided into two groups. Group Gn RHa: 65 patients who took Gn RHa for inducing ovulation. Group HCG: 57 patients who took HCG for inducing ovulation. Patients with PCOS receiving IUI after ovulation induction treatment by CC were randomly divided into two groups. Group Gn RHa: 50 patients who took Gn RHa for inducing ovulation. Group HCG: 50 patients who took HCG for inducing ovulation. Observed the ovulation serum E2, P levels and the thickness of endometrium of patients after the mid luteal phase induced ovulation, the rates of pregnancy, multiple pregnancy, ectopic pregnancy and early abortion, the incidence of ovarian hyperstimulation syndrome(OHSS), luteinizing unruptured follicle syndrome(LUFS) and the cysts formation in next menstrual period of the non-pregnant patients, and compared the effects of Gn RHa, and HCG-induced follicle maturation and ovulation induction of ovulation in patients with PCOS.Results 1 No statistical difference was found between group GnRHa and group HCG who receiving guidance intercourse after ovulation induction treatment in patients' ages, BMI, duration of infertility, basal serum hormone, the treatment period of HMG, the dose of HMG and the endometrial thickness before ovulation induction(P>0.05). There was no statistical difference between group Gn RHa and group HCG who receiving IUI after ovulation induction treatment(P>0.05). 2 Subjects with treatment of guidance after ovulation induction, No statistical difference was found in serum E2, P levels and the thickness of endometrium in the mid-luteal after triggering between group Gn RHa and group HCG(P>0.05). No statistical difference was found in pregnancy rate, multiple pregnancy rate, early abortion rate between group Gn RHa and group HCG. The incidence of LUFS, OHSS and the occurrence of ovarian cyst in the next menstruation was lower in group Gn RHa than group HCG(P<0.05). No ectopic pregnancy was found in both two groups. 3 Subjects who receiveing the treatment of IUI after ovulation, no statistical difference was found in serum FSH, LH, E2 after triggering 36 hours, endometrial thickness and midluteal phase serum E2 and P between group Gn RHa and group HCG(P>0.05). No statistical difference was found in pregnancy rate, multiple pregnancy rate, early abortion rate between group Gn RHa and group HCG. The incidence of LUFS, OHSS and the occurrence of ovarian cyst in the next menstruation was lower in group Gn RHa than group HCG(P<0.05). There were two cases ectopic pregnancy in the group of Gn RHa and no ectopic pregnancy in the group HCG.Conclusions Gn RHa can apply for the treatment of patients with PCOS to stimulate ovulation and the pregnancy rate could be equivalent to HCG treatment. Gn RHa can effectively improve the pregnancy outcome and reduce the occurrence of complications compared to the conventional luteal support scheme. The patients with PCOS who have a history of LUFS, many follicles mature at the same time and the tendency of OHSS in CC stimulate ovulation treatment, application of Gn RHa follicle maturation and ovulation induction may be a more safe and effective trigger" approach.