en دوره طولانی مهار GnRH در سیکل های تحریک تخمک گذاری کنترل شده: اثرات آن بر روی نتایج IVF؟ Original Article Original Article <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">مقدمه</span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">: تجویز طولانی مدت </span></span><span dir="LTR"><span style="font-size:11.0pt;">GnRH-a</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در سیکل&shy;های </span></span><span dir="LTR"><span style="font-size:11.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> ممکن است فوایدی در نتایج درمانی آن&shy;ها داشته باشد. </span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">هدف</span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">: در این مطالعه هدف ما، بررسی اثر تجویز طولانی مدت </span></span><span dir="LTR"><span style="font-size:11.0pt;">GnRH-a</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در نتایج تحریک تخمک&shy;گذاری کنترل&shy;شده در بیماران </span></span><span dir="LTR"><span style="font-size:11.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> می&shy;باشد.</span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">مواد و روش&shy; ها</span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">: در این مطالعه گذشته</span></span><span dir="LTR"><span style="font-size:11.0pt;">&shy;</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نگر، 55 بیمار تحت درمان با </span></span><span dir="LTR"><span style="font-size:11.0pt;">GnRH-a</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> به مدت بیش از 10 روز با 55 بیمار تحت همین درمان با مدت کمتر از 10 روز مطالعه و از نظر مشخصات دموگرافیک، نسبت اووسیت&shy;های متافاز </span></span><span dir="LTR"><span style="font-size:11.0pt;">II</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> (</span></span><span dir="LTR"><span style="font-size:11.0pt;">MII</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">)، نسبت امبریوهای گرید </span></span><span dir="LTR"><span style="font-size:11.0pt;">I</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> (</span></span><span dir="LTR"><span style="font-size:11.0pt;">GI</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">)، نسبت بلاستوسیت&shy;ها، باروری، لانه&shy;گزینی و میزان حاملگی کلینیکی با یکدیگر مقایسه شدند.</span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتایج</span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">: متوسط تعداد مراجعه به بیمارستان در بیماران تحت درمان طولانی مدت&nbsp;&nbsp;</span></span><span style="font-family:times new roman,serif;"><span style="font-size:11.0pt;">GnRH-a,&nbsp;</span></span><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">0/4</span></span></span><span dir="RTL"><span style="font-family:times new roman,serif;"><span style="font-size:11.0pt;">&plusmn;</span></span></span><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">2/6&nbsp;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">&nbsp;بار مراجعه بود. همانطور که انتظار میرفت میزان دوز کلی </span></span><span dir="LTR"><span style="font-size:11.0pt;">GnRH-a</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> جهت کنترل منفی هیپوفیز در دو گروه متفاوت بود (</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">0/001></span></span><span dir="LTR"><span style="font-size:11.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">). </span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">همچنین تفاوت معنی&shy;داری بین نسبت اووسیت&shy; های </span></span><span dir="LTR"><span style="font-size:11.0pt;">MII</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">، امبریوهای </span></span><span dir="LTR"><span style="font-size:11.0pt;">GI</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> و بلاستوسیست&shy; ها در دو گروه مشاهده گردید (0/001></span></span><span dir="LTR"><span style="font-size:11.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">، 0/01></span></span><span dir="LTR"><span style="font-size:11.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> و 0/05></span></span><span dir="LTR"><span style="font-size:11.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">). تفاوت بین دیگر پارامترها معنی&shy; دار نبود. </span></span><br> &nbsp;<strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتیجه&shy; گیری: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">تجویز طولانی&shy; مدت </span></span><span dir="LTR"><span style="font-size:11.0pt;">GnRH-a</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در حین مهار تخمدان&shy;ها در بیماران </span></span><span dir="LTR"><span style="font-size:11.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">،</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> ممکن است اثر مثبتی روی اووسیت&shy; ها و امبریوها داشته باشد ولی این اثرات در میزان کلی حاملگی مشاهده نمی&shy; گردد. </span></span> <strong>Background:</strong> Prolonged GnRH-a administration in IVF cycles may have some advantages related to the treatment outcomes.<br> <strong>Objective: </strong>In this study, we aimed to analyse the effect of prolonged gonadotropin releasing hormone agonist (GnRH-a) administration on controlled ovarian hyperstimulation outcomes of in vitro fertilization (IVF) patients.<br> <strong>Materials and Methods:</strong> In this retrospective study, 55 patients with a GnRH-a administration period more than 10 days were compared with 55 patients whose same period was ?10 days with respect to the demographic characteristics, metaphase II (MII) oocyte ratio, grade I (GI) embryo ratio, blastocyst ratio, fertilization, implantation, and the clinical pregnancy rates.<br> <strong>Results: </strong>The mean hospital visit count of the prolonged GnRH-a patients was 2.6&plusmn;0.4. As we expected, total GnRH-a doses used during hypophyseal down regulation were significantly different between the groups (p<0.0001). MII oocyte, G1 embryo and the blastocyst ratios were also significantly different between the groups (p<0.0001; p<0.01 and p<0.05). All the other parameters were insignificant.<br> <strong>Conclusion:</strong> Prolonged GnRH-a administration during ovarian suppression in IVF patients may have positive impacts on the oocytes and the embryos, but this affect may not be observed in the overall pregnancy rates. GnRH agonist, IVF outcome, Embryo quality GnRH agonist, IVF outcome, Embryo quality 155 160 http://ijrm.ir/browse.php?a_code=A-10-31-42&slc_lang=en&sid=1 Ozlem Gun Eryilmaz drozlemgun@yahoo.com Yes Department of Obstetrics and Gynecology, Zekai Tahir Burak Women Education and Research Hospital, Mithatpasa cad. Hamamonu, Ankara, Turkey Esma Sarikaya No Department of Obstetrics and Gynecology, Zekai Tahir Burak Women Education and Research Hospital, Mithatpasa cad. Hamamonu, Ankara, Turkey Melike Doganay No Department of Obstetrics and Gynecology, Zekai Tahir Burak Women Education and Research Hospital, Mithatpasa cad. Hamamonu, Ankara, Turkey Leyla Mollamahmutoglu No Department of Obstetrics and Gynecology, Zekai Tahir Burak Women Education and Research Hospital, Mithatpasa cad. Hamamonu, Ankara, Turkey Nedim Cicek No Department of Obstetrics and Gynecology, Zekai Tahir Burak Women Education and Research Hospital, Mithatpasa cad. Hamamonu, Ankara, Turkey