AZALMIŞ OVER RESERVİ OLAN OLGULARDA LONG GNRH AGONİST, GNRH ANTAGONİST VE MİKRODOZ FLARE-UP AGONİST PROTOKOLLERİNİN IVF SONUÇLARI ÜZERİNE ETKİSİ

Amaç: Düşük over rezervi tanısıyla IVF programına alınan hastalarda uygulanan mikro doz flre up , GnRHantagonist ve long GnRH agonist gibi farklı protokollerin IVF başarısındaki etkinliğinin karşılaştıılması.Gereç ve yöntemler: Sağlık Bilimleri Üniversitesi Ankara Etlik Zübeyde Hanım Eğiti ve Araştıma HastanesiIVF Kliniğine Ocak 2010 ve Mayıs 2019 tarihleri arasında başvuran ve düşük over reservi tanısı alan hastalarçalışmaya dahil edildi. 713 kadın kullanılan kontrollü ovarian stiulasyon protokellerine göre 3 gruba ayrıldı:Grup A(n=327) GnRH antagonist protokol, Grup B(n=184), long GnRH agonist protokol ve Grup C (n=202)mikrodoz flre-up protokol olarak belirlendi. Gruplar arasında ovarian stiulasyon karekteristileri ve klinikgebelik sonuçları karşılaştııldı.Bulgular:713 olgu çalışmaya dahil edildi. Long GnRH agonist protokol grubu, Grup A ve Grup C ile karşılaş-tııldığında stiulasyon süresi anlamlı olarak daha uzun ve matur oosit sayısı daha fazla bulundu(p=0.001).Total gonadotropin dozu ve siklus iptal oranları grup C de anlamlı olarak yüksektip=0.001).Gruplar arasındatoplanan oosit sayısı açısından anlamlı fark bulunmadı. Klinik gebelik oranları bakımından gruplar arasındaanlamlı fark tespit edilmedi(p=0.337).Sonuç: Düşük over reservi olan kadınlarda tedavi süresini ve maliyet azaltması nedeniyle , GnRH antagonistprotokolü ilk tedavi seçeneği olarak düşünülebilir.

Effect of long GnRH Agonist, GnRH Antagonist and Microdose Flare-up Agonist protocols on IVF results in patints with diminished ovarian reserve

Objectie: To compare the effct of gonadotropin-releasing hormone (GnRH) antagonist protocol, microdose flre-up protocol and long GnRH agonist protocol in patints receiving in vitro fertiizatin/ intracytılasmic sperm injectin (IVF/ICSI)treatment due to poor response . Materials and methods: In a retrospectie study, the records of patints who were poor responders attnding University of Health Sciences Ankara Etlik Zübeyde Hanım Womens Health Applicatin and Research Center, IVF Clinic between January , 2010 and May, 2019 were retrieved. Overall 713 patints were divided into 3 groups: Group A(n=327) gonadotropin-releasing hormone (GnRH) antagonist protocol, Group B(n=184) long GNRH analog protocol, Group C( n=202) microdose flre-up protocol. The ovarian stiulatin characteristis as well as the clinical pregnancy rates were compared between groups. Results: Seven hundred and thirteen patints included in the study.Treatment duratin and number of mature oocytes were signifiantly higher in women undergoing the long GnRH agonist regimen compared with Group A and Group C(p=0.001 for both). The cycle cancellatin rate and total gonadotropin dose were signifiantly higher in group C (p=0.001). A signifiant diffrence was not observed with respect to the number of retrieved oocytes . No statitially signifiant diffrences were detected in clinical pregnancy rates between the groups (p=0.337). Conclusion: GnRH antagonist regimen may be preferable to other protocols as it could decrease the cost and treatment duratin in poor responders

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Bozok Tıp Dergisi-Cover
  • ISSN: 2146-4006
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2015
  • Yayıncı: Bozok Üniversitesi
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