Aygül DEMİROL, Gürkan BOZDAĞ, Timur GÜRGAN

GnRH Agonistleri Ve Antagonistleri: Güncel Yönleri

Semptomatik endometriosis ve leimyoma gibi sebeplerden dolayı zaten kullanılmakta olan GnRH agonistleri, yardımcı üreme tekniklerinin ortaya çıkmasıyla birlikte kendisine daha da geniş kullanım alanı bulmuştur. İlk uygulandığında mevcut hipofizer gonadotropinlerin hızlıca salınmasına bağlı ortaya çıkan alevlendirici (flare up) etkisi aslında istenmeyen bir yan etkisi olsa da erken spontan ovulasyonu baskılamak amacıyla yakın zamana kadar alternatifsiz olarak kullanılagelmiştir. Alevlendirici etkisinin olmadığı, ovaryan hiperstimülasyon sendromunun daha az izlendiği, toplam eksojen gonadotropin ihtiyacının daha düşük olduğu iddia edilen GnRH antagonistlerinin ortaya çıkması ile birlikte, klinisyenler arasında hangisinin genel yönleriyle daha uygun olduğu hakkında ki tartışmalar yapılan karşılaştırmalı çalışmalar ile halen devam etmektedir. Yapılan bu derlemede, mevcut klinik çalışmalar ve güncel bilgiler çerçevesinde, GnRH agonist ve antagonistleri gerek kontrollü ovaryan stimülasyon performansları, gerekse de gebelik oranları açısından detaylıca değerlendirilmektedir. Anahtar kelimeler: GnRH agonist, GnRH antagonist, In vitro fertilizasyon, Yardımcı üreme teknikleri, Gebelik.

Anahtar Kelimeler:

GnRH agonist, GnRH antagonist, In vitro fertilizasyon, Yardımcı üreme teknikleri, Gebelik.

GnRH Agonists And Antagonists: Current Aspects

GnRH agonists have been widely accepted in some clinical aspects such as symptomatic endometriosis or leimyomata. Since assisted reproductive technologies have been appeared, GnRH agonists have expanded its clinical usage. Although the flare up effect of agonists has been noted, its application during controlled ovarian hyperstimulation in order to inhibit premature ovulation had been valid without an alternative medication for a long period. Once the GnRH antagonists had been discovered which have been attributed to have no flare up effect with a lower ovarian hyperstimulation syndrome incidence and decrease in requirement of total exogenous gonadotrophin use, it is still controversial whether GnRH antagonists or agonists are more suitable for a optimum ovarian stimulation protocol. In this review, the performance of agonists and antagonists during controlled ovarian hyperstimulation and clinical or ongoing pregnancy rates have been detailed with clinical studies and recent recommendations. Key words: GnRH agonist, GnRH antagonist, In vitro fertilization, Assisted reproduction technics, Pregnancy.

Keywords:

GnRH agonist, GnRH antagonist, In vitro fertilization, Assisted reproduction technics, Pregnancy.,

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