CLOMIPHENE CITRATE AND HMG - AN ALTERNATIVE STIMULATION PROTOCOL FOR SELECTED FAILED IN-VITRO FERTILIZATION PATIENTS

被引：18

作者：

BENADIVA, CA ^{[1
]}

DAVIS, O ^{[1
]}

KLIGMAN, I ^{[1
]}

LIU, HC ^{[1
]}

ROSENWAKS, Z ^{[1
]}

机构：

[1] NEW YORK HOSP,CORNELL MED CTR,CTR REPROD MED & INFERTIL,DEPT OBSTET & GYNECOL,NEW YORK,NY 10021

来源：

JOURNAL OF ASSISTED REPRODUCTION AND GENETICS | 1995年 / 12卷 / 01期

关键词：

IN VITRO FERTILIZATION; CLOMIPHENE CITRATE; OVARIAN STIMULATION;

D O I：

10.1007/BF02214121

中图分类号：

Q3 [遗传学];

学科分类号：

071007 ; 090102 ;

摘要：

Purpose: This study was carried out to evaluate the potential role of the combination clomiphene citrate/human menopausal gonadotropin (CC/hMG) for patients who failed previous in vitro fertilization (IVF) attempts with gonadotropin-releasing hormone analogs (GnRH-a) and/or exogenous gonadotropins. Methods: Patients were stimulated with CC/hMG (n = 93) after unsuccessfully undergoing 182 gonadotropin cycles with (n = 106) or without (n = 76) luteal-phase GnRH-a. Cancellation rate, length of stimulation, and peak estradiol levels did not differ significantly between the two regimens. Results: Although fewer oocytes were retrieved when the CC/hMG combination was used, 16 patients were able to successfully achieve a pregnancy (26.2% delivery rate/transfer). When daily follicle stimulating hormone (FSH) levels were measured in two successive cycles in those women who conceived with the CC/hMG stimulation, baseline levels did not differ when compared with a previous GnRH-a/hMG cycle. Nevertheless, serum FSH levels rose rapidly and remained higher in the GnRH-a/hMG cycle, reaching significantly higher levels on day of human chorionic gonadotropin (hCG) administration. Conclusion: Selected patients who failed previous IVF attempts with gonadotropins with or without GnRH analogs may benefit from the addition of CC to their ovarian stimulation protocol.

引用

页码：8 / 12

页数：5

共 13 条

[1]

Benadiva C.A., Ben-Rafael Z., Strauss J.F., Mastroianni L., Flickinger G.L., Ovarian response of individuals to different doses of human menopausal gonadotropin, Fertil Steril, 49, (1988)

[2]

van Hoof M.H.A., Alberda A.T., Huisman G.J., Zeilmaker G.H., Leerentveld R.A., Doubling the human menopausal gonadotropin dose in the course of an in-vitro fertilization treatment cycle in low responders: a randomized study, Hum Reprod, 8, (1993)

[3]

Lejeune B., Barlow P., Puissant F., Delvigne A., Vanrysselberge M., Leroy F., Use of buserelin acetate in an in vitro fertilization program: a comparison with classical clomiphene citrate-human menopausal gonadotropin treatment, Fertil Steril, 54, (1990)

[4]

Tummon I.S., Daniel S.A.J., Kaplan B.R., Nisker J.A., Yuzpe A.A., Randomized, prospective comparison of luteal leuprolide acetate and gonadotropins versus clomiphene citrate and gonadotropins in 408 first cycles of in vitro fertilization, Fertil Steril, 58, (1992)

[5]

Dor J., Ben-Shlomo I., Levran D., Rudak E., Yunish M., Mashiach S., The relative success of gonadotropin-releasing hormone analogue, clomiphene citrate, and gonadotropin in 1,099 cycles of in vitro fertilization, Fertil Steril, 58, (1992)

[6]

Liu H-C, Lai Y-M, Davis O., Berkeley A.S., Graf M., Grifo J., Cohen J., Rosenwaks Z., Improved pregnancy outcome with gonadotropin releasing hormone agonist stimulation is due to the improvement in oocyte quantity rather than quality, J Assist Reprod Genet, 9, (1992)

[7]

Diamond M.P., Hill G.A., Webster B.W., Herbert C.M., Rogers B.J., Osteen, Maxson W.S., Vaughn K.W., Wentz A.C., Comparison of human menopausal gonadotropin, clomiphene citrate, and combined human menopausal gonadotropin-clomiphene citrate stimulation protocols for in vitro fertilization, Fertil Steril, 46, (1986)

[8]

Ron-El R., Caspi E., Golan A., Nachum H., Herman A., Soffer Y., Weinraub Z., A comparison of clomiphene/menotropins and d-Trp6-LH-RH/menotropins cycles of IVF-ET in the same patient, Int J Fertil, 36, (1991)

[9]

Pellicer A., Lightman A., Diamond M.P., Russell J.B., de Cherney A., Outcome of in vitro fertilization in women with low response to ovarian stimulation, Fertil Steril, 47, (1987)

[10]

Ben-Rafael Z., Strauss J.F., Mastroianni L., Flickinger G.L., Differences in ovarian stimulation in human menopausal gonadotropin treated women may be related to follicle-stimulating hormone accumulation, Fertil Steril, 46, (1986)

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