https://scholars.lib.ntu.edu.tw/handle/123456789/454443
標題: | A patient friendly corifollitropin alfa protocol without routine pituitary suppression in normal responders | 作者: | Wang H.-L Lai H.-H Chuang T.-H Shih Y.-W Huang S.-C Lee M.-J SHEE-UAN CHEN |
公開日期: | 2016 | 卷: | 11 | 期: | 4 | 來源出版物: | PLoS ONE | 摘要: | The release of corifollitropin alfa simplifies daily injections of short-acting recombinant follicular stimulating hormone (rFSH), and its widely-used protocol involves short-acting gonadotropins supplements and a fixed GnRH antagonist regimen, largely based on follicle size. In this study, the feasibility of corifollitropin alfa without routine pituitary suppression was evaluated. A total of 288 patients were stimulated by corifollitropin alfa on cycle day 3 following with routine serum hormone monitoring and follicle scanning every other day after 5 days of initial stimulation, and a GnRH antagonist (0.25 mg) was only used prophylactically when the luteinizing hormone (LH) was ≧ 6 IU/L (over half of the definitive LH surge). The incidence of premature LH surge (≧ 10 IU/L) was 2.4% (7/288) before the timely injection of a single GnRH antagonist, and the elevated LH level was dropped down from 11.9 IU/L to 2.2 IU/L after the suppression. Two hundred fifty-one patients did not need any antagonist (87.2% [251/288]) throughout the whole stimulation. No adverse effects were observed regarding oocyte competency (fertilization rate: 78%; blastocyst formation rate: 64%). The live birth rate per OPU cycle after the first cryotransfer was 56.3%(161/286), and the cumulative live birth rate per OPU cycle after cyrotransfers was 69.6% (199/286). Of patients who did and did not receive GnRH antagonist during stimulation, no significant difference existed in the cumulative live birth rates (78.4% vs. 68.3%, p = 0.25). The results demonstrated that the routine GnRH antagonist administration is not required in the corifollitropin-alfa cycles using a flexible and hormone-depended antagonist regimen, while the clinical outcome is not compromised. This finding reveals that the use of a GnRH antagonist only occasionally may be needed. ? 2016 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/454443 | ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0154123 | SDG/關鍵字: | cetrorelix; corifollitropin alfa; luteinizing hormone; recombinant chorionic gonadotropin; recombinant follitropin; recombinant follitropin plus recombinant luteinizing hormone; recombinant luteinizing hormone; triptorelin; follicle stimulating hormone, human, with HCG C-terminal peptide; follitropin; gonadorelin; hormone antagonist; luteinizing hormone; adult; Article; birth rate; blastocyst; cohort analysis; controlled study; feasibility study; female; fertilization; fertilization in vitro; human; infertility; live birth; luteinizing hormone blood level; major clinical study; oocyte donation; ovulation induction; patient monitoring; personalized medicine; retrospective study; antagonists and inhibitors; blood; cytology; drug effects; in vitro fertilization; male; middle aged; ovary follicle; ovulation induction; pregnancy; pregnancy rate; procedures; young adult; Adult; Birth Rate; Female; Fertilization in Vitro; Follicle Stimulating Hormone, Human; Gonadotropin-Releasing Hormone; Hormone Antagonists; Humans; Luteinizing Hormone; Male; Middle Aged; Ovarian Follicle; Ovulation Induction; Pregnancy; Pregnancy Rate; Young Adult |
顯示於: | 醫學系 |
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