Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Comparison between GnRH Antagonist and Agonist Long Protocols in Poor Responders

불량반응군에서 GnRH Antagonist와 Agonist Long Protocol의 비교

  • Choi, Ji-Young (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Ku, Seung-Yup (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Hoon (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Jee, Byung-Chul (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Suh, Chang-Suk (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Seok-Hyun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Choi, Young-Min (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Jung-Gu (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Moon, Shin-Yong (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
  • 최지영 (서울대학교 의과대학 산부인과학교실) ;
  • 구승엽 (서울대학교 의과대학 산부인과학교실) ;
  • 김훈 (서울대학교 의과대학 산부인과학교실) ;
  • 지병철 (서울대학교 의과대학 산부인과학교실) ;
  • 서창석 (서울대학교 의과대학 산부인과학교실) ;
  • 김석현 (서울대학교 의과대학 산부인과학교실) ;
  • 최영민 (서울대학교 의과대학 산부인과학교실) ;
  • 김정구 (서울대학교 의과대학 산부인과학교실) ;
  • 문신용 (서울대학교 의과대학 산부인과학교실)
  • Received : 2010.05.17
  • Accepted : 2010.09.08
  • Published : 2010.09.30
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Abstract

Objective: The objective of this retrospective study was to compare the in vitro fertilization (IVF) outcomes of gonadotropinreleasing hormone (GnRH) agonist and GnRH antagonist protocols in poor responders. Methods: A total of 172 cycles in subjects with less than 5 oocytes retrieved treated with either GnRH agonist long protocols or antagonist protocols were included. The outcome variables such as numbers of growing follicles and retrieved oocytes, and the fertilization rate were evaluated as the main outcome measures. Results: There was no difference in regard to the numbers of growing follicles and oocytes, and fertilization rate between the two groups. $E_2$ level on Day 7/8, mean gonadotropin dose, and the days of stimulation were shown to be statistically different (p<0.01, respectively). Conclusion: Considering that similar results were observed with less time and gonadotropin dose, GnRH antagonist protocol may be considered as a preferable choice over GnRH agonist protocols in poor responders.

목 적: 본 후향적 연구는 성선자극호르몬분비호르몬 작용제 (gonadotropin-releasing hormone [GnRH] agonist)와 길항제 (GnRH antagonist) 치료를 받은 불량반응군의 결과를 비교, 분석하고자 하였다. 연구방법: 총 172회의 체외수정시술 주기에서 GnRH agonist 또는 antagonist protocol로 과배란유도를 시행받고 채취된 난자의 수가 5개 이하인 불량반응군을 대상군으로 하였다. 난포 및 채취된 난자의 수, 수정률 등의 결과를 두 군 간에 비교하였다. 결 과: GnRH agonist long protocol과 antagonist protocol 두 군 간에 난포 및 난자의 수와 수정률은 차이를 보이지 아니하였다. 반면, 과배란유도 제7/8일의 혈중 $E_2$ 농도는 GnRH antagonist군에서 더 높았던 반면, 사용한 평균 성선자극호르몬의 용량은 유의하게 적고 과배란유도 기간은 짧은 것을 확인할 수 있었다 (각각 p<0.01). 결 론: 불량 반응군에서 GnRH agonist long protocol에 비하여 GnRH antagonist protocol의 경우 노력이 상대적으로 적게 필요한 반면 비슷한 임상적 결과를 고려할 때, GnRH antagonist protocol이 상대적으로 우수한 것으로 생각된다.

Keywords

References

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