目的:有证据表明卵泡期孕酮升高[FPPR]对新鲜体外受精[IVF]周期产生不利影响。每日单次剂量的西曲瑞克已用于防止早期促黄体生成素(LH)激增。我们推测,尽管接受了单次每日剂量治疗,但每日剂量加倍可能对早期LH激增的患者产生积极影响。然而,在卵巢低反应(POR)患者中,每日双倍剂量的西曲瑞克似乎可引起FPPR.
方法:人绒毛膜促性腺激素[hCG]注射天数,将接受单日剂量西曲瑞克的POR患者(第1组,n=59)的孕酮水平与接受双日剂量西曲瑞克的患者(第2组,n=75)的孕酮水平进行比较.两组的人口统计学数据相似。检测到患有FPPR的患者,和孕酮水平的比较,使用0.8、1.0和1.2[ng/mL]的孕酮作为截止水平,在两组患者之间进行。
结果:第2组FPPR患者在hCG日期间孕酮水平明显升高,与预期相反。当第1组患者使用孕酮截止水平为0.8、1.0和1.2[ng/mL]时,15.3%,13.6%,6.8%的患者发展为FPPR,当孕酮截止值分别为0.8、1.0和1.2[ng/mL]时,检测结果为45.3%,30.7%,和21.3%,分别。观察到两组之间孕酮水平的显着统计学差异。
结论:虽然一些作者最初认为西曲瑞克的双倍日剂量更有效地抑制早期LH升高,我们已经看到,与单一日剂量方案相比,它增加了FPPR更多。我们建议使用冷冻周期而不是新鲜周期,以便在似乎从较高每日剂量的西曲瑞克中受益的患者中具有更好的子宫内膜容受性。
OBJECTIVE: There is evidence that follicular phase progesterone rise [FPPR] adversely affects fresh in vitro fertilization [IVF] cycles. A single daily dose of cetrorelix has been used to prevent early luteinizing Hormone (LH) surge. We speculated that doubling the daily dose might have a positive effect in patients who have early LH surges despite receiving the single daily dose treatment. However, a double daily dose of cetrorelix seems to cause FPPR in poor ovarian response (POR) patients.
METHODS: On human chorionic gonadotropin [hCG] injection days, the progesterone levels of POR patients who received a single daily dose of cetrorelix (group 1, n = 59) were compared with progesterone levels of the patients who received a double daily dose of cetrorelix (group 2, n = 75). The two groups had statistically similar demographic data. The patients who had FPPR were detected, and a comparison of progesterone levels, using 0.8, 1.0, and 1.2 [ng/mL] of progesterone as cut-off levels, was made between patients of both groups.
RESULTS: FPPR patients in group 2 had significantly higher progesterone levels during hCG day, contrary to expectations. When progesterone cut-off levels of 0.8, 1.0, and 1.2 [ng/mL] were used for group 1 patients, 15.3%, 13.6%, and 6.8% of the patients developed FPPR, respectively When the progesterone cut-off levels of 0.8, 1.0, and 1.2 [ng/mL] were used for group 2, the results detected were 45.3%, 30.7%, and 21.3%, respectively. A significant statistical difference in progesterone levels was observed between the groups.
CONCLUSIONS: While the double daily dose of cetrorelix was initially thought to more effectively suppress early LH rise by some authors, we have seen that it increases the FPPR more when compared to a single daily dose regime. We suggest using frozen cycles instead of fresh cycles in order to have better endometrial receptivity in patients who seem to benefit from higher daily doses of cetrorelix.