Abstract：Objective To study the effectiveness and safety of ganirelix for assisted reproductive technology (ART).Methods Databases of Medline, Embase and Cochrane library were searched for randomised, double-blind, placebo-controlled trials (RCTs) concerning glucosamine treatment of OA. Quality evaluation were assessed by Cochrane quality evaluation standards and Meta-analysis by using Rev Man 5.3 were performed.Results A total of 13 studies contributed to the meta-analysis. Meta-analysis showed that there was no significant difference in the effective rate of general patients treated with Garniric compared with GnRH-a long-term regimen, but the incidence of adverse reactions was significantly reduced. It was significantly reduced for both efficacy and the adverse event rate for poor responds patients with ganirelix. Compared with triptorelin and buserelin, the efficacy was significantly reduced for patient with ganirelix. While comparing with leuprolide and nafarelin, there was no significant difference on efficacy and the adverse event rate for patience with ganirelix.Conclusion From the safety and efficacy of drug, ganirelix maybe a choice for COS in general patients and PCOS patients receiving ART.
[1] DYER S, CHAMBERS GM, DE MOUZON J, et al. International Committee for Monitoring Assisted Reproductive Technologies world report: Assisted Reproductive Technology 2008, 2009 and 2010. Hum Reprod. 2016, 31(7): 1588-1609. [2] NICE, National Institute for Health and Clinical Excellence. Fertility : Assessment and treatment for people with fertility problems (NICE clinical guideline 156). guidance. nice. org. uk. 2013-02-20 [3] 中华医学会生殖医学分会. 促性腺激素释放激素拮抗剂方案在辅助生殖领域中使用的专家共识[J]. 中华妇产科杂志, 2015, 50(11): 805-809. [4] 乔杰, 马彩虹, 刘嘉茵,等. 辅助生殖促排卵药物治疗专家共识[J]. 中华生殖与避孕杂志, 2015, 35(4): 211-223. [5] LAMBALK CB, BANGA FR, HUIRNE JA, et al. GnRH antagonist versus long agonist protocols in IVF: a systematic review and meta-analysis accounting for patient type[J]. Human Reproduction Update, 2017, 23(5): 560-579. [6] AL-INANY HG, ABOULGHAR M. Gonadotropin-releasing hormone antagonists for assisted conception: Cochrane Review[J]. Cochrane Database of Systematic Reviews, 2001, 4(4): CD001750. [7] HIGGINS JP, OMPSON SG, DEEKS JJ, et al. Measuring inconsistency in meta-analyses [J]. BMJ, 2003, 327(7414): 557-560. [8] The,European Orgalutran Study Group. Treatment with the gonadotropin- releasing hormone antagonist ganirelix in women undergoing ovarian simulation with recombinant follicle stimulating hormone is effective, safe and convenient : Results of a controlled, randomised, multicenter trial[J]. Human Reproduction, 2000, 15: 1490-1498. [9] Group EMEOS. Comparable clinical outcome using the GnRH antagonist ganirelix or a long protocol of the GnRH agonist triptorelin for the prevention of premature LH surges in women undergoing ovarian stimulation.[J]. Human Reproduction, 2001, 16(4): 644-651. [10]FLUKER M, GRIFO J, LEADER A, et al. Efficacy and safety of ganirelix acetate versus leuprolide acetate in women undergoing controlled ovarian hyperstimulation [J]. Fertility & Sterility, 2001, 75(1): 38-45. [11]BADRAWI A, AL-INANY H, HUSSEIN M, et al. Agonist versus antagonist in ICSI cycles: A randomized trial and cost effectiveness analysis[J]. Middle East Fertility Society Journal, 2005, 10(1):49-54. [12]ROMBAUTS L, HEALY D, NORMAN RJ, et al. A comparative randomized trial to assess the impact of oral contraceptive pretreatment on follicular growth and hormone profiles in GnRH antagonist-treated patients. Human reproduction, 2006 ; 21(1): 95-103. [13]LAINAS TG, PETSAS GK, ZORZOVILIS IZ, et al. Initiation of GnRH antagonist on Day 1 of stimulation as compared to the long agonist protocol in PCOS patients. A randomized controlled trial: effect on hormonal levels and follicular development. Human reproduction, 2007, 22(6): 1540-1546. [14]LAINAS TG, SFONTOURIS IA, ZORZOVILIS IZ, et al. Flexible GnRH antagonist protocol versus GnRH agonist long protocol in patients with polycystic ovary syndrome treated for IVF: a prospective randomised controlled trial (RCT). Human reproduction, 2010, 25(3): 683-689. [15]FIROUZABADI RD, AHMADI S, OSKOUIAN H, et al. Comparing GnRH agonist long protocol and GnRH antagonist protocol in outcome the first cycle of ART. Archives of gynecology and obstetrics, 2010, 281(1): 81-85. [16]GARCIA-VELASCO JA, BERMEJO A, RUIZ F, et al. Cycle scheduling with oral contraceptive pills in the GnRH antagonist protocol vs the long protocol: a randomized, controlled trial. Fertility and sterility, 2011, 96(3): 590-593. [17]HAYDARDEDEOGLU B, KILICDAG EB, PARLAKGUMUS AH, et al. IVF/ICSI outcomes of the OCP plus GnRH agonist protocol versus the OCP plus GnRH antagonist fixed protocol in women with PCOS: a randomized trial. Archives of gynecology and obstetrics, 2012,286(3): 763-769. [18]PRAPAS Y, PETOUSIS S, DAGKLIS T, et al. GnRH antagonist versus long GnRH agonist protocol in poor IVF responders: a randomized clinical trial. European journal of obstetrics, gynecology, and reproductive biology, 2013, 166(1): 43-46. [19]QIAO J, LU G, ZHANG HW, et al. A randomized controlled trial of the GnRH antagonist ganirelix in Chinese normal responders: high efficacy and pregnancy rates. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 2012, 28(10): 800-804. [20]TOFTAGER M, BOGSTAD J, BRYNDORF T, et al. Risk of severe ovarian hyperstimulation syndrome in GnRH antagonist versus GnRH agonist protocol: RCT including 1050 first IVF/ICSI cycles. Human reproduction, 2016, 31(6): 1253-1264. [21]胡琳莉, 黄国宁, 孙海翔,等. 促排卵药物使用规范(2016)[J]. 生殖医学杂志, 2017, 26(4): 302-307. [22]陈军玲, 刘素英, 李路,等. 促性腺激素释放激素拮抗剂方案与激动剂长方案应用于新鲜胚胎移植患者的疗效比较[J]. 中国临床医学, 2017, 24(3): 339-342.
