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促性腺激素释放激素拮抗剂(GnRH-A)在控制性超促排卵(COH)中被用于防止早现的内源性促黄体激素(LH)峰,与GnRH激动剂(GnRH-a)相比较,GnRH-A具有以下优点:没有低雌激素副作用、没有点火效应、起效快且作用可逆。2011年最新的循证医学证据显示,GnRH-A方案联合GnRH-a促发卵子最终成熟在获得了与GnRH-a方案类似的临床妊娠率的同时,可以显著降低卵巢过度刺激综合征(OHSS)的发病率,该方案值得进一步推广和优化。但由于GnRH-A导致体内LH水平显著低于生理水平,可能影响部分患者的卵泡发育,以及GnRH-a应用后对LH活性的抑制可能对黄体功能产生不利影响,LH活性的补充成为近来研究的热点。hCG可以结合体内的LH受体,且半衰期更长、亲和力更高,其效能是LH的6倍左右,hCG在拮抗剂方案中的应用值得进一步研究。
Gonadotropin-releasing hormone antagonists (GnRH-A) are used to prevent premature presence of endogenous luteinizing hormone (LH) peaks in controlled hypersurgery (COH), interacting with GnRH agonists (GnRH-a) In comparison, GnRH-A has the following advantages: no low estrogen side effects, no ignition effect, rapid onset and reversible effects. The latest evidence-based evidence from 2011 shows that the GnRH-A regimen in combination with GnRH-a triggers the eventual maturation of ovaries to achieve ovarian hyperstimulation syndrome (OHSS) while achieving similar clinical pregnancy rates as the GnRH-a regimen, The incidence of this program deserves further promotion and optimization. However, LH levels in vivo are significantly lower than physiological levels due to GnRH-A, which may affect the follicular development in some patients and inhibition of LH activity after GnRH-a administration may adversely affect corpus luteum function. Supplementation of LH activity has been recently studied Hot spots. hCG can bind LH receptor in vivo with longer half-life and higher affinity, and its potency is about 6 times that of LH. The application of hCG in antagonist programs deserves further study.