en آیا تحریک دوگانه باعث بهبود میزان یوپلویدی در زنان با پاسخ نرمال می شود؟ یک مطالعه مقطعی Reproductive Endocrinology Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">با معرفی آنالوگ هورمون محرک دوگانه آزاد&shy;کننده گنادوتروپین (</span></span><span dir="LTR" style="font-size:10.0pt">GnRH</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و گنادوتروپین جفتی نوترکیب انسانی (</span></span><span dir="LTR" style="font-size:10.0pt">hCG</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">)، نشان داده شد که زنان با سابقه نسبت تخمک بالغ کم و سندرم فولیکول خالی از محرک دوگانه سود می&shy;برند.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بررسی اینکه آیا تحریک دوگانه بلوغ تخمک با آگونیست</span></span> <span dir="LTR" style="font-size:10.0pt">GnRH</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">(</span></span><span dir="LTR" style="font-size:10.0pt">GnRHa</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) همراه با </span></span><span dir="LTR" style="font-size:10.0pt">hCG</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">می‌تواند بر میزان یوپلویدی تأثیر بگذارد و نتایج لقاح آزمایشگاهی را برای زنان دارای پاسخ‌دهی طبیعی بهبود بخشد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش&shy; ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در این مطالعه مقطعی، 494 زن تحت تحریک کنترل‌شده تخمدان با</span></span><span dir="LTR" style="font-size:10.0pt">hCG</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">&nbsp;(274 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">n</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) یا تحریک دوگانه (220 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">n</span> <span dir="LTR" style="font-size:10.0pt">hCG+GnRHa,</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) در بیمارستان </span></span><span dir="LTR" style="font-size:10.0pt">Acibadem Maslak</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، بخش ناباروری، از ژانویه 2019 تا 2022 وارد شدند. آزمایش ژنتیک قبل از لانه</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">گزینی برای آنیوپلوئیدی بر روی همه شرکت</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">کنندگان انجام شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هر دو گروه ویژگی‌های پایه و بالینی مشابهی داشتند. از 881 جنین بیوپسی شده، 312 (4/35</span></span><span lang="FA" style="font-size:11.0pt"><span majalla="" sakkal="" style="font-family:">٪</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) به عنوان </span></span><span dir="LTR" style="font-size:10.0pt">euploid</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در گروه محرک </span></span><span dir="LTR" style="font-size:10.0pt">hCG</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> گزارش شد. در گروه محرک دوگانه، 186 (8/29</span></span><span lang="FA" style="font-size:11.0pt"><span majalla="" sakkal="" style="font-family:">٪</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) از 623 جنین غربالگری شده به عنوان یوپلوید گزارش شد. گروه </span></span><span dir="LTR" style="font-size:10.0pt">hCG</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نرخ یوپلویدی بالاتری به ازای هر جنین بیوپسی شده داشت، اگرچه این تفاوت از نظر آماری معنی</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">دار نبود (5/26 </span></span><span lang="FA" style="font-size:10.0pt">&plusmn;</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 4/31 در مقابل 3/33 </span></span><span lang="FA" style="font-size:10.0pt">&plusmn;</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 5/26، 05/0 </span></span><span lang="FA" style="font-size:10.0pt">< </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">).</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه &shy;گیری: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در زنان با پاسخ نرمال، افزودن </span></span><span dir="LTR" style="font-size:10.0pt">GnRHa</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">برای بلوغ نهایی فولیکولی به </span></span><span dir="LTR" style="font-size:10.0pt">hCG</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> باعث بهبود میزان یوپلویدی نمی‌شود.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></span><br> &nbsp;</div> <div style="text-align: justify;"><span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Background:</b> With the introduction of the dual triggering-gonadotropin-releasing hormone (GnRH) analog and recombinant human chorionic gonadotropin (hCG) combination, women with a history of low mature oocyte proportion and empty follicle syndrome were shown to benefit from the dual trigger.</span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Objective: </b>To investigate whether dual triggering of oocyte maturation with a GnRH agonist (GnRHa) combined with hCG can affect the euploidy rate and improve in vitro fertilization outcomes for normoresponder women.</span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Materials and Methods:</b> In this cross-sectional study, 494 women who underwent controlled ovarian stimulation with hCG (n = 274) or dual triggering (hCG+GnRHa, n = 220) at Acibadem Maslak hospital, Assisted Reproductive Unit, from January 2019-2022 were enrolled in this study. Preimplantation genetic testing for aneuploidy was performed on all participants. </span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Results:</b> Both groups had similar baseline and clinical characteristics. Of the 881 embryos biopsied, 312 (35.4%) were reported as euploid in the hCG trigger group; in the dual trigger group, 186 (29.8%) of 623 screening embryos were reported as euploid. The hCG group had a higher euploidy rate per biopsied embryo, although the difference was not statistically significant (31.4 &plusmn; 26.5 vs. 26.5 &plusmn; 33.3, p > 0.05). </span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b>Conclusion:</b> In normoresponders, adding GnRHa for final follicular maturation to hCG did not improve the euploidy rate.</span></span></div> هورمون آزاد­کننده گنادوتروپین, گنادوتروپین کوریونی, غربالگری قبل از لانه­گزینی, آنیوپلوئیدی. Gonadotropin-releasing hormone, Chorionic gonadotropin, Preimplantation screening, Aneuploidy. 395 402 http://ijrm.ir/browse.php?a_code=A-10-2256-1&slc_lang=en&sid=1 Sule Yildirim Kopuk suleyildirim@msn.com 0000-0002-5020-8323 Yes Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey. Zeynep Ece Utkan Korun zeynepeceutkan@yahoo.com 0000-0002-1595-569X No Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey. Aysen Yuceturk aysenyuceturk@yahoo.com.tr 0000-0002-7065-6588 No Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey. Ozge Karaosmanoglu ozge61@gmail.com 0000-0001-8184-4747 No Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey. Caglar Yazicioglu yazicioglucaglar@hotmail.com 0000-0003-1665-4909 No Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey. Bulent Tiras bulenttiras@acibadem.com 0000-0003-2297-3332 No Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey. Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey. Yigit Cakiroglu dryigit1@yahoo.com 0000-0002-2779-8599 No Acibadem Maslak Hospital, Assisted Reproductive Technologies Unit, Istanbul, Turkey. Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.