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대한생식의학회지 제22권 제2호 2010년

체외수정시술시 과배란에 Clomiphene Citrate와 일회 Human Menopausal Gonadotropin 병합요법의 효용성에 관한 연구

중앙대학교 의과대학 산부인과학교실;중앙대학교 의과대학 산부인과학교실;중앙대학교 의과대학 산부인과학교실;

이소영;이상훈;배도환;,

Study on Clomiphene Citrate with Single Human Menopausal Gonadotropin for Controlled Ovarian Hyperstimulation

Lee, So-Young;Lee, Sang-Hoon;Bae, Do-Whan;

Department of Obstetrics & Gynecology, College of Medicine, Chung-Ang University Hospital;Department of Obstetrics & Gynecology, College of Medicine, Chung-Ang University Hospital;Department of Obstetrics & Gynecology, College of Medicine, Chung-Ang University Hospital;

Many types of medication regimens have been used for controlled ovarian hyperstimulation for assisted reproductive technique(ART). Questions are now being raised regarding how to lower the escalating costs of assisted reproduction and decrease the extent of patient discomfort and disruption of life style without sacrificing success rates. In this investigation, from January 1994 through August 1994 patients presenting to the Chung-Ang university hospital, infertility clinic were offered the option of the clomiphene citrate (CC)/single Human Menopausal Gonadotropin(HMG) combination and conventional GnRH-agonist combination method. 60 patients (78 cycles) were given CC/single HMG combination as a study group, and 78 patients (102 cycles) were given conventional GnRH-a combined ultrashort protocol as a control group for IVF-ET program and the resulting number of oocyte retrieved, embryo produced, and pregnancy initiated were compared. There were no differences between the two groups in mean age, serum $E_2$, LH and FSH level on menstrual cycle day 2. HMG requirement was 2 ampules in study group and $24.2{\pm}6.8$ ampules in control group. On the day of HCG injection, serum LH and FSH levels were not significantly different, but serum $E_2$, was significantly higher in control group(p<0.001). There was relatively well endometrial quality in control group but not significant compare to study group. In control group, numbers of retrieved oocyte and transferred embryo were significantly more than study group(p<0.001). Fertilization rate was not significantly different in the two groups and pregnancy rates were 20.2% in study group 28.4% in control group(p<0.001). CC/single HMG protocol for IVF-ET is less expensive than GnRH-a combined ultrashort protocol and minimizes patients discomfort. In addition, CC/single HMG protocol produces acceptable pregnancy rate and represents an attractive alternative to select patients undergoing IVF-ET.

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