研究開発・学会発表

【発表の概要】

OBJECTIVE: This study was designed to evaluate whether GnRH antagonist
(cetrorelix) given every other day could prevent premature luteinization
and obtain good pregnancy outcome in women undergoing IVF fresh treatment.

DESIGN: Retrospective study.

MATERIALS AND METHODS: A total of 96 women receiving ovulation
stimulation IVF cycles were allocated three groups according to GnRH antagonist in two multiple pattern doses or single dose (0.25mg each dose) until the day of hCG administration. Thirty-six women with every other day GnRH administration were classified to Group-1. Women with daily administration (n＝43) were grouped Group-2, and Group-3 was defined as 17 women with single administration of controlled ovarian stimulation last day. A total of GnRH antagonist was administrated to each woman over 2 times in the Group-1 and over 4 times in the Group-2. Embryo transfer was performed in fresh IVF cycle and other surplus embryos were continued to cultured until day 5 and assess the blastocyst formation rate.

RESULTS: Basal FSH, age, periods of controlled ovarian stimulation,
amount of FSH/hMG and peak E2 values showed similar trends in the three groups. During FSH/hMG stimulation, 8(22.2%) of 36 women in Group-1 had LH fluctuation, and 2 (25%) out of 8 women with LH fluctuation had premature LH rises(>10 IU/l) during GnRH antagonist administration. No LH rises were observed in Group-2. There was a LH rise in 1(16.7%) out of 6 women with LH fluctuation in Group-3. Mean number of oocytes retrieval, fertilized, cleavage and good quality embryos were similar in the three roups. No ovulation was occured at oocyte pick-up in the three groups. lastocysts were obtained 43(51.8%) out of 83 embryos in the Group-1 as same number as 64(50.8%) out of 126 embryos in the Group-2. Clinical pregnancy rate with fresh embryo transfer was 36.1% (13/36) in the Group-1 and 29.4%(5/17) in the Group-3. The PR in the Group-1 was relatively higher than the PR(14.0%, 6/43) in Group-2 (p<0.05).

CONCLUSIONS: Every other day GnRH antagonist administration is
as effective as daily administration in terms of oocytes retrieval and
early cleavage rate and blastocyst formation rate. This study shows
that alternate day administration of GnRH antagonist protcol may increase
the some risk of premature LH rise, but may increased pregnancy
outcome of fresh cycle embryo transfer compared with daily administration
protocol.
Supported by: None.