試管嬰兒新科技－故意慢打Gnrh-ant可改善卵巢功能低的試管嬰兒成功率！

2014.08.09

 試管嬰兒新科技－故意慢打Gnrh-ant可改善卵巢功能低的試管嬰兒成功率！

 
2014年5月《生育與節育期刊》針對30個病人，她們之前打排卵針的反應都很低，他把這些病人分成2組：一組是用傳統的欣得泰療程，另外一組刻意慢一點才打欣得泰，佔21人，其他9人使用傳統欣得泰療程。
 
當卵泡大些才打欣得泰，結果他們發現
慢一點打欣得泰可以有較多的卵泡，平均是4.2顆：2.4顆，
而取卵數為4.9顆：2.2顆，
懷孕率為23.8％，著床率為9.8％。
 
這份研究最後的結論是：在卵巢功能不佳的這一群病人，可以故意慢一點才打欣得泰，可取得較好的反應，取到較多的卵子，成功率較高。
 
Fertil Steril. 2014 May;101(5):1308-14. doi: 10.1016/j.fertnstert.2014.01.050. Epub 2014 Mar 14.
A novel "delayed start" protocol with gonadotropin-releasing hormone antagonist improves outcomes in poor responders.
Cakmak H1, Tran ND1, Zamah AM1, Cedars MI1, Rosen MP2.
Author information
 
Abstract
OBJECTIVE:
To investigate whether delaying the start of ovarian stimulation with GnRH antagonist improves ovarian response in poor responders.
DESIGN:
Retrospective study.
SETTING:
Academic medical center.
PATIENT(S):
Thirty patients, who responded poorly and did not get pregnant with conventional estrogen priming antagonist IVF protocol.
INTERVENTION(S):
Delayed-start antagonist protocol (estrogen priming followed by early follicular-phase GnRH antagonist treatment for 7 days before ovarian stimulation).
MAIN OUTCOME MEASURE(S):
Number of dominant follicles and mature oocytes retrieved, mature oocyte yield, and fertilization rate.
RESULT(S):
The number of patients who met the criteria to proceed to oocyte retrieval was significantly higher in the delayed-start protocol [21/30 (70%)] compared with the previous conventional estrogen priming antagonist cycle [11/30 (36.7%)]. The number of dominant follicles was significantly higher in the delayed-start (4.2 ± 2.7) compared with conventional (2.4 ± 1.3) protocol. In patients who had oocyte retrieval after both protocols (n = 9), the delayed start resulted in shorter ovarian stimulation (9.4 ± 1.4 days vs. 11.1 ± 2.0 days), higher number of mature oocytes retrieved (4.9 ± 2.0 vs. 2.2 ± 1.1), and a trend toward increased fertilization rates with intracytoplasmic sperm injection (ICSI; 86 ± 17% vs. 69 ± 21%) compared with conventional protocol. After delayed start, the average number of embryos transferred was 2.8 ± 1.4 with implantation rate of 9.8% and clinical pregnancy rate of 23.8%.
CONCLUSION(S):
The delayed-start protocol improves ovarian response in poor responders by promoting and synchronizing follicle development without impairing oocyte developmental competence.