en نتایج بارداری در سیکل های تحت آگونیست هورمون آزاد کننده گونادوتروپین طولانی اثر و کوتاه اثر در افراد با ذخیره طبیعی تخمدان: یک کارآزمایی بالینی Fertility & Infertility 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:">تاکنون، توافقی در مورد اینکه کدام یک از دو پروتکل آگونیست هورمون آزاد&shy;کننده گنادوتروپین کارایی بالاتر و درصد باروری بیشتری دارد، وجود ندارد.</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:">هدف از مطالعه حاضر، مقایسه کارایی دز کاهش یافته آگونیست هورمون آزاد&shy;کننده گنادوتروپین طولانی اثر و کوتاه اثر بر میزان باروری است.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></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 کارآزمایی بالینی تصادفی کنترل شده، تعداد 400 زن به طور تصادفی به دو گروه تقسیم شدند: گروه دوز کاهش&shy;یافته آگونیست هورمون آزادکننده گنادوتروپین طولانی اثر (گروه 1, 25/1 میلی&shy;گرم دکاپتیل) و گروه آگونیست هورمون آزادکننده گنادوتروپین کوتاه اثر (گروه 2, 5/0 میلی&shy;گرم/روز استات بوسرلین). این مطالعه بین ژوئیه 2019 و ژوئیه 2020 در کلینیک پزشکی مهر در رشت، ایران انجام شد. نتایج حاملگی شیمیایی و کلینیکی بین گروه &shy;ها مقایسه 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:">تفاوت معنی&shy;داری در ضخامت آندومتر، تعداد کل تخمک&shy;های کسب شده و متافاز 2، سطح پروژسترون و استرادیول سرم در روز تجویز گنادوتروپین جفتی انسان، نرخ لقاح و جنین&shy;های با کیفیت بالا بین دو گروه وجود نداشت. مدت زمان تحریک (7/1 </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:"> 8/10 در مقابل 1/2 </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:">10، 001/0 </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:">) و دوز&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;گنادوتروپین&shy;های مصرفی (9/945 </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:">4/2939 در مقابل 1/1247 </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:"> 2441، 001/0 </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:">) در گروه 2 نسبت به گروه 1 به طور معنی&shy;داری بیشتر بود. نرخ لانه&shy;گزینی، بارداری شیمیایی و بارداری کلینیکی میان دو گروه تفاوت معنی&shy;داری نداشت. درصد بالاتری از سندرم تحریک تخمدان در گروه 2 مشاهده شد (005/0 </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><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></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:">به دلیل درصد کمتر سندرم تحریک تخمدان در گروه 1 و نتایج باروری مشابه در هر دو گروه، بهتر بودن پروتکل طولانی اثر نسبت به پروتکل کوتاه اثر مشاهده شد.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span></div> <div class="msocomtxt" id="_com_2" language="JavaScript" on="" style="text-align: justify;"><span style="font-family:Times New Roman;"><span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><b><span style="font-size:12.0pt"><span style="background:white">Background</span>:</span></b><span style="font-size:12.0pt"> There is </span><span style="font-size:12.0pt">no</span><span style="font-size:12.0pt"> agreement on which of the 2 gonadotropin-releasing hormone (GnRH) agonist protocols are the most efficient, neither </span><span style="font-size:12.0pt">there is</span><span style="font-size:12.0pt"> any consensus on which one </span><span style="font-size:12.0pt">yields</span><span style="font-size:12.0pt"> a better clinical pregnancy percentage</span><span style="font-size:12.0pt">.</span><span dir="RTL" lang="FA" style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><b><span style="font-size:12.0pt">Objective:</span></b><span style="font-size:12.0pt"> The</span><span style="font-size:12.0pt"> present study aims to compare the effectiveness of reduced dosages of long- and short-acting GnRH agonists on pregnancy </span><span style="font-size:12.0pt">outcomes.</span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><b><span style="font-size:12.0pt">Materials and Methods:</span></b><span style="font-size:12.0pt"> In this randomized controlled clinical trial, 400 women were </span><span style="font-size:12.0pt">randomly assigned to</span><span style="font-size:12.0pt"> 2 groups (n = 200/</span><span style="font-size:12.0pt">group</span><span style="font-size:12.0pt">): the reduced dosage of long-acting GnRH agonist group (</span><span style="font-size:12.0pt">group 1</span><span style="font-size:12.0pt">, 1.25 mg Decapeptyl) and </span><span style="font-size:12.0pt">the </span><span style="font-size:12.0pt">short-acting GnRH agonist group (</span><span style="font-size:12.0pt">group 2</span><span style="font-size:12.0pt">, 0.5 mg/day Buserelin Acetate). The study was </span><span style="font-size:12.0pt">conducted</span><span style="font-size:12.0pt"> at </span><span style="font-size:12.0pt">Mehr Medical Institute, Rasht, Iran between July 2019 and July 2020. Biochemical and clinical pregnancy were compared between groups.</span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><b><span style="font-size:12.0pt">Results:</span></b><span style="font-size:12.0pt"> No significant </span><span style="font-size:12.0pt">differences</span><span style="font-size:12.0pt"> were observed in </span><span style="font-size:12.0pt">the </span><span style="font-size:12.0pt">endometrial </span><span style="font-size:12.0pt">lining</span><span style="font-size:12.0pt">, the total number of retrieved and metaphase-II oocytes, progesterone, and serum estradiol </span><span style="font-size:12.0pt">levels on</span><span style="font-size:12.0pt"> human chorionic gonadotropin day, fertilization rate, and top-quality embryos between </span><span style="font-size:12.0pt">the </span><span style="font-size:12.0pt">groups.</span><span style="font-size:12.0pt"> The</span><span style="font-size:12.0pt"> duration of induction (10.8 &plusmn; 1.7 vs. 10 &plusmn; 2.1, p < 0.001) and </span><span style="font-size:12.0pt">the total</span><span style="font-size:12.0pt"> dosage of gonadotropins (2939.4 &plusmn; 945.9 vs. 2441 &plusmn; 1247.1, p < 0.001) </span><span style="font-size:12.0pt">were significantly</span><span style="font-size:12.0pt"> greater in group 2 than </span><span style="font-size:12.0pt">in </span><span style="font-size:12.0pt">group 1. No </span><span style="font-size:12.0pt">significant differences</span><span style="font-size:12.0pt"> were observed between </span><span style="font-size:12.0pt">the 2</span><span style="font-size:12.0pt"> groups in </span><span style="font-size:12.0pt">terms of </span><span style="font-size:12.0pt">implantation</span><span style="font-size:12.0pt"> rate</span><span style="font-size:12.0pt">, chemical</span><span style="font-size:12.0pt"> pregnancy rate</span><span style="font-size:12.0pt">, and clinical pregnancy rate. </span><span style="font-size:12.0pt">A</span> <span style="font-size:12.0pt">higher percentage of ovarian hyperstimulation syndrome was observed</span><span style="font-size:12.0pt"> in group 2 (p = 0.005).<span style="font-family:"Times New Roman","serif""></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><b><span style="font-size:12.0pt">Conclusion:</span></b><span style="font-size:12.0pt"> Due to a lower percentage of ovarian hyperstimulation syndrome in group 1 and similar assisted reproductive technology </span><span style="font-size:12.0pt">outcomes</span><span style="font-size:12.0pt"> in both groups, the long protocol was </span><span style="font-size:12.0pt">found to be superior to the short protocol.</span></span></span></span></span></div> هورمون آزادکننده گنادوتروپین, لقاح آزمایشگاهی, نتیجه بارداری, سندرم تحریک بیش از حد تخمدان. Gonadotropin-releasing hormone, In vitro fertilization, Pregnancy outcome, Ovarian hyperstimulation syndrome. 759 766 http://ijrm.ir/browse.php?a_code=A-10-875-3&slc_lang=en&sid=1 Roya Kabodmehri dr.royakabodmehri@gmail.com 0000-0003-4162-6846 No Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Nasrin Ghanami nasringhanami@gmail.com 0000-0003-0060-3955 No Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Azadeh Raoufi az.raoufi@gmail.com 0000-0002-6005-1999 No Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran. Marzieh Mehrafza marzieh.mehrafza@gmail.com 0000-0002-0476-6535 Yes Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran. Zahra Nikpouri z.nikpouri@gmail.com 0000-0002-0476-6535 No Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran. Elmira Hosseinzadeh Elmira.hosseinzadeh@yahoo.com 0000-0002-5895-4937 No Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran. Ahmad Hosseini prof_hosseini@yahoo.com 0000-0003-1871-2957 No Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran.