| 학회지 검색 | HOME > 논문 및 학회지 > 학회지 검색 |
대한생식의학회지 제36권 제1호 2010년
고령 불임여성의 체외수정술시 최소자극법의 효용성
울산대학교 의과대학 서울아산병원 산부인과
김소라, 김정훈*, 이진경, 전균호, 김성훈, 채희동, 강병문,
Minimal Stimulation using rhFSH and GnRH Antagonist for IVF Treated Patients of Advanced Age
So-Ra Kim, Chung-Hoon Kim*, Jin-Kyoung Lee, Gyun-Ho Jeon, Sung-Hoon Kim, Hee-Dong Chae, Byung-Moon Kang
Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center
.
Objective: This study was performed to investigate the effectiveness of minimal stimulation using rhFSH and GnRH antagonist compared with GnRH antagonist multidose protocol (MDP) in IVF treated patients with aged 40 and above. Methods: Seventy-five patients with aged 40 and above were equally randomized to minimal stimulation group (n=37) or GnRH antagonist MDP group (n=38). For minimal stimulation group, ultrasound monitoring was started on cycle day 7 or 8. Daily injections of 0.25 mg cetrorelix together with 150 IU rhFSH were started from the day at 13~14 mm of a leading follicle diameter. For GnRH antagonist MDP group, daily injections of 225 IU rhFSH were initiated from cycle day 2 and GnRH antagonist was started at a dose of 0.25 mg/day on rhFSH stimulation day 6 or the day at 13~14 mm of leading follicle diameter. In both groups, transvaginal ultrasound-guided oocyte retrieval was performed. According to cleavage and morphologic characteristics of embryos, embryos were transferred 3 to 5 days after oocyte retrieval. Results: There were no differences in patients' characteristics and cycle cancellation rate between the two groups. Total dose and duration of rhFSH used were significantly fewer and shorter in minimal stimulation group than those in GnRH antagonist MDP group. The numbers of oocytes retrieved, mature oocytes and transferred embryos were also lower in minimal stimulation group. However, there were no significant differences in the clinical pregnancy rate and miscarriage rate between the two groups. Conclusions: This study demonstrates that minimal stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP with fewer dose and days of rhFSH used, and thus can be a cost-effective alternative in women aged 40 and above.
키워드 : Minimal stimulation protocol, Pregnancy rate, IVF, Advanced age
교신저자 : chnkim@amc.seoul.kr
전문 파일 : 
