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Comparisons of the serum hormone level of GnRH antagonist protocol versus GnRH agonist protocol in IVF-ET cycleObjectiveTo compare the effects on endocrine of the two regimens by hormone measure at different time points in patients undergoing in vitro fertilization and embryo transfer(IVF-ET),analyzed drug function characteristics,while compare of hormone changes in patients after transplantation,and provide the basis for rational luteum function support.MethodsChoose thirty women with normal ovarian function need do IVF-ET treatment in Shandong University Qilu Hospital Reproductive Medical Center from October 2015 to March 2016.15 cases applied GnRH long protocol as a research group(group I)and 15 patients that applied GnRH-ant protocol as control group(group II).Follicle-stimulation hormone(FSH),Luteinzing hormone(LH),estradiol(E2)and progesterone(P)concentrations in serulil were measured on the follow days:(1)The first day of Gn injection in two regimens(basic level);(2)The 5,7 day after Gn injection in two regimens;(3)The HCG day,the oocyte pick-up(OPU)day and embryo-transfer;(4)The 3,5,14 day after embryo-transfer.To compare the serum hormone levels and the correlation with pregnancy outcomes.The curves of hormone levels at different time points were plotted,to make a comparision between two regimens for their respective hormonal trends characteristic,and try to analyze the effect of on endocrine and corpus luteum function.Result1.Patients in Group I experienced a pituitary down-regulation process,serum E2 levels on Gn administer day and 5 days after Gn administration in Group I were significant lower than that in group II.7 days after Gn administration,serum E2 levels in Group I was lower than that in group II,but the difference was not significant.On the day of HCG administration,oocyte retrieval and embryo-transfer,serum E2 levels in Group I was higher than that in group II,the difference was not statistically significant.On the third day and the fifth day after embryo transfer,the level of E2 in group I was lower than that in group II,and on the fifth day after embryo transfer,the difference was statistically significant.The overall trend of E2 level in two groups were consistent.2.Patients in group I with pituitary down-regulation has lower serum FSH level than group II on Gn administration day.There was no significant difference in serum FSH level between the two groups in the process of COH and embryo-transfer and at all time points after transplantation.The overall trend of FSH level in two groups were consistent.3.The level of serum LH in group I was lower than that in group II on Gnadministration day,and the difference was statistically significant.7 days after Gn administration and on the day of HCG administration,patients in group I has higher levels of LH than group II.On the day of oocyte retrieval,embryo-transfer,and 3 days and 5 days after embryo transfer,the LH level in group I was significant lower than that in group II.On the 14th day after transplantation,LH level between the two groups has no significant difference.4.There was no significant difference in serum P level between two groups in the process of COH.Conclusion1.The trend of serum E2 in two groups were consistent in the process of controlled ovarian hyperstimulation.2.The trend of serum FSH in two groups were consistent in the process of controlled ovarian hyperstimulation.3.GnRH antagonist could quickly inhibit pituitary function,reduce serum LH level,and effectively prevent the early LH peak,to prevent premature ovulation.4.After stop the application of GnRH-a or GnRH-ant,serum LH level of patients in both groups continued to decrease,and the LH in long-term regimen was maintained at a low level,that is,the long-term regimen had a greater inhibitory effect on the pituitary than the antagonist.5.After stop the application of GnRH-a,the LH level was significantly reduced in long-term regimen,and it was proved that although the pituitary descending regulation,GnRH-a still has a certain stimulating effect on the pituitary,and the pituitary retains certain reactivity.Part? Comparison of IVF-ET outcome between GnRH antagonist protocol and GnRH agonist long protocol in patients with normal ovarion functionObjectiveTo compare the clinical curative effects of GnRH antagonist protocol and GnRH agonist protocol on patients with normal ovirion function in IVF-ET treatment,and to provide the basis for the rational apply of COH programs.MethodsRetrospective analysis 248 IVF-ET cycles in GnRH agonist protocol(group I)from January 2015 to June 2016 of Shandong University Qilu Hospital Reproductive Medical Center,matched 248 cycles in GnRH antagonist protocol at the same period according to age,body mass index(BMI)and the basic FSH level as group ?.Make a statistics of Gn treating time,Gn dose,serum E2 level on HCG day,and the numbers of egg,portable embryo and high quality embryo in two groups,make a comparison of the two programs on clinical efficacy.Result1.There was no significant difference in Gn dose between two groups(P>0.05);In group ?,Gn treating time was longer than that in group II(P=0.004).2.The serum E2 level on HCG day in group I were significantly higher than those in group ?(P<0.05).3.Compared with group ?,the numbers of egg and M? egg were higher in group,but the differences has not statistically significance;The number of portable embryos in group ? was higher than that in group ?,the difference was statistically significant(P=0.013).4.The positive rate of biochemical pregnancy was higher in group 1(183/272)than that of group ?(161/291),and the difference was statistically significant(P = 0.04).Group I received 152 cycles of clinical pregnancy(152/272),compared with group II(144/291),the difference has no statistical significant(P = 0.076).There were no significant differences in biochemical pregnancy rate,clinical pregnancy rate and abortion rate between the two groups in fresh embryo transfer cycles.Conclusion1.Patients with normal Ovarian function in IVF cycle has similar clinical outcome in the application of GnRH antagonist protocol and GnRH agonist protocol.2.For patients with similar general conditions,the use of antagonist program could obtain similar numbers of mature egg and transplantable embryo compare with the long program.3.GnRH antagonist protocol has the advantage of short treatment period,which application is convenient and flexible.4.GnRH antagonist protocol may reduce the occurrence of Ovarian Hyperstimulation Syndrome(OHSS)and improve the safety of IVF therapy. |
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