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대한생식의학회지 제20권 제1호 2010년
체외수정시술을 위한 성선자극호르몬 과배란유도에 Poor Response를 나타낸 환자에서 GnRH Analogue의 사용
고려대학교 의과대학 산부인과;고려대학교 의과대학 산부인과;고려대학교 의과대학 산부인과;
김선행;이희경;구병삼;,
GnRH Analogue in Controlled Ovarian Hyperstimulation for Gonadotropin Poor Responder
Kim, Sun-Haeng;Lee, Hee-Kyung;Ku, Pyong-Sahm;
Department of Obstetrics and Gynecology, Medical College, Korea University;Department of Obstetrics and Gynecology, Medical College, Korea University;Department of Obstetrics and Gynecology, Medical College, Korea University;
In 27 patients with the past history of poor response to the gonadotropin superovulation induction due to poor follicular growth or permature surge of endogenous luteinizing hormone, the effectiveness of pituitary supperssion with the gonadotropin releasing hormone agonist(GnRH-a) in in vitro fertilization(IVF) program was evaluated in 43 cycles using a combination regimen of D-Trp-6 LHRH(Decapeptyl, Ferring)and FSH/hMG from June, 1989 to August, 1990 at Korea University Hospital IVF Clinic. At midluteal phase of menstrual cycle, Decapeptyl-CR was administered by long-term protocol to minimize initial agonistic effect of endogenous gonadotropins. After the confirmation of pituitary suppression, about 2-3 weeks after GNRH-a administration, ovarian follicle growth was stimulated with FSH/hMG and followed by transvaginal ultrasonic measurement of follicle size and by monitoring of serm E2 and LH if necessary. When compared with the control group stimulated with gonadotropin regimen only, the cancellation rate and occurrence rate of premature LH surge during gonadotropin treatment were significantly lower in study group(11.6% and 2.4%, respectively). There is no significant differences in the mean number of aspirated oocytes, fertilization/cleavage rate, embryo transfer(ET) rate, and mean number of embryos transferred between the two groups. The pregnancy rate per treatment cycle, 16.3%, and per ET cycle, 23.3%, were significantly higher in the study group compared with those of control group. These data suggest that GnRH-a therapy is effective for previous poor responder In gonadotropin superovulation induction for IVF.
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