체외수정시술을 위한 과배란유도시 Nafarelin 과 Triptorelin 사용에 따른 임상성적의 비교

Abstract

Gonadotropin-releasing hormone agonists(GnRH-a) vary in structure and route of administration. We performed this study to compare patient response to intranasal nafarelin acetate versus subcutaneous triptorelin as adjuncts to ovulation induction for in vitro fertilization(IVF). From October 1995 to May 1996, sixty-four patients with tubal factor infertility entering their 79 cycles of IVF were randomized to receive either intranasal nafarelin acetate(Group Ⅰ, 38 cycles) or subcutaneous triptorelin(Group Ⅱ, 41 cycles). Controlled ovarian hyperstimulation(COH) using luteal long protocol of GnRH-a was used in all patients. Patient characteristics in the two groups did not differ significantly, nor did sperm parameters or endocrine profiles. There was no significant difference in ovarian response as indicated by duration of GnRH-a administration before ovarian stimulation, number of ampules of gonadotropin used and duration of gonadotropin administration in ovarian stimulation, and serum E( ) level and number of follicles(≥14mm) on the day of hCG administration between the two groups. There were no significant differences in clinical results of oocyte and embryo obtained such as number of oocytes retrieved, oocytes fertilized, embryos cleaved, embryos frozen, and embryos transfered between the two groups. There were also no significant differences between group Ⅰ and group Ⅱ in clinical pregnancy rate(31.6% versus 34.1%) and abortion rate per clinical pregnancy(8.3% versus 14.3%).

This study suggests that intranasal nafarelin acetate as well as subcutaneous triptorelin can be used successfully in ovulation induction using luteal long protocol of GnRH-a.

Gonadotropin-releasing hormone agonists(GnRH-a) vary in structure and route of administration. We performed this study to compare patient response to intranasal nafarelin acetate versus subcutaneous triptorelin as adjuncts to ovulation induction for in vitro fertilization(IVF). From October 1995 to May 1996, sixty-four patients with tubal factor infertility entering their 79 cycles of IVF were randomized to receive either intranasal nafarelin acetate(Group Ⅰ, 38 cycles) or subcutaneous triptorelin(Group Ⅱ, 41 cycles). Controlled ovarian hyperstimulation(COH) using luteal long protocol of GnRH-a was used in all patients. Patient characteristics in the two groups did not differ significantly, nor did sperm parameters or endocrine profiles. There was no significant difference in ovarian response as indicated by duration of GnRH-a administration before ovarian stimulation, number of ampules of gonadotropin used and duration of gonadotropin administration in ovarian stimulation, and serum E( ) level and number of follicles(≥14mm) on the day of hCG administration between the two groups. There were no significant differences in clinical results of oocyte and embryo obtained such as number of oocytes retrieved, oocytes fertilized, embryos cleaved, embryos frozen, and embryos transfered between the two groups. There were also no significant differences between group Ⅰ and group Ⅱ in clinical pregnancy rate(31.6% versus 34.1%) and abortion rate per clinical pregnancy(8.3% versus 14.3%).

This study suggests that intranasal nafarelin acetate as well as subcutaneous triptorelin can be used successfully in ovulation induction using luteal long protocol of GnRH-a.