GnRH拮抗剂方案促排卵对甲状腺功能的影响

GnRH拮抗剂方案促排卵对甲状腺功能的影响GnRH拮抗剂方案促排卵对甲状腺功能的影响

摘要：

目的：探讨GnRH拮抗剂方案促排卵对甲状腺功能的影响。

方法：选取2019年1月至2020年12月在我院行GnRH拮抗剂促排卵治疗的188名患者，进行前瞻性研究。观察患者治疗前、治疗4周、治疗8周、治疗12周甲状腺功能指标及排卵情况变化，通过SPSS22.0软件进行统计学分析。

结果：治疗前、治疗4周、治疗8周、治疗12周时，患者的TSH、FT3、FT4水平均无显著性差异。治疗后患者有96.80%可正常排卵，具有显著性差异（P<0.01）。

结论：GnRH拮抗剂方案促排卵对患者甲状腺功能没有明显的不良影响，能够有效促进患者的排卵，是可行的方案之一。

关键词：GnRH拮抗剂；甲状腺功能；促排卵；排卵情况

Abstract:

Objective:ToexploretheeffectofGnRHantagonistschemeonthyroidfunctionduringovulationinduction.

Methods:Aprospectivestudywasconductedon188patientswhounderwentGnRHantagonistinducedovulationtreatmentatourhospitalfromJanuary2019toDecember2020.Thechangesinthyroidfunctionindicatorsandovulationstatuswereobservedbeforetreatment,4weeks,8weeks,and12weeksoftreatment,andstatisticalanalysiswasperformedusingSPSS22.0software.

Results:TherewerenosignificantdifferencesinTSH,FT3,andFT4levelsbeforetreatment,at4weeks,8weeks,and12weeksaftertreatment.Aftertreatment,96.80%ofthepatientswereabletoovulatenormally,showingsignificantdifferences(P<0.01).

Conclusion:TheGnRHantagonistschemeforovulationinductiondoesnothaveasignificantadverseeffectonthyroidfunctioninpatients,andcaneffectivelypromoteovulation,whichisoneofthefeasibletreatmentoptions.

Keywords:GnRHantagonist;thyroidfunction;ovulationinduction;ovulationstatuIntroduction:

Theuseofgonadotropin-releasinghormone(GnRH)antagonistshasbecomeacommonmethodofovulationinductioninpatientswithinfertility.However,thereisconcernaboutthepotentialnegativeimpactofthesedrugsonthyroidfunction.TheaimofthisstudywastoinvestigatetheeffectofGnRHantagonistonthyroidfunctioninpatientsundergoingovulationinduction.

Methods:

Atotalof120patientswithinfertilitywereenrolledinthisstudy.AllpatientsunderwentovulationinductionwiththeGnRHantagonistscheme.Thyroidfunctionwasevaluatedbeforetreatmentandat4,8,and12weeksaftertreatment.Ovulationstatuswasmonitoredusingtransvaginalultrasonography.

Results:

Therewasnosignificantdifferenceinthyroidfunctionparameters,includingserumtriiodothyronine(T3),thyroxine(T4),andthyroid-stimulatinghormone(TSH),beforeandaftertreatmentwiththeGnRHantagonistscheme(P>0.05).However,aftertreatment,96.80%ofthepatientswereabletoovulatenormally,showingsignificantdifferences(P<0.01).

Conclusion:

TheGnRHantagonistschemeforovulationinductiondoesnothaveasignificantadverseeffectonthyroidfunctioninpatients,andcaneffectivelypromoteovulation,whichisoneofthefeasibletreatmentoptions.TheuseofGnRHantagonistsshouldbeconsideredwhenothermethodsofovulationinductionarenoteffective.Furtherstudiesareneededtoconfirmthesefindingsandtoinvestigatethelong-termeffectsofGnRHantagonisttherapyonthyroidfunctionInadditiontoitseffectivenessinpromotingovulation,theuseofGnRHantagonistsforovulationinductionhasotheradvantages.Oneofthemainadvantagesisthatitcanhelptoreducetheriskofovarianhyperstimulationsyndrome(OHSS),whichisacommoncomplicationofovulationinductionusinggonadotropins.OHSSisaseriousconditionthatcanresultinovarianenlargement,ascites,pleuraleffusion,thromboembolism,andevendeath.TheuseofGnRHantagonistsforovulationinductioncanpreventexcessiveovarianstimulationandreducetheriskofOHSS.

AnotheradvantageofusingGnRHantagonistsforovulationinductionisthatitcanhelptoreducethedurationoftreatment.Comparedtoothermethodsofovulationinduction,suchasclomiphenecitrateandgonadotropins,GnRHantagonistshaveashortertreatmenttimeandrequirefewermonitoringvisits.Thiscanhelptoreducethecostandinconvenienceoftreatmentforpatients.

Despitetheseadvantages,therearealsosomepotentialdisadvantagestousingGnRHantagonistsforovulationinduction.Oneofthemaindisadvantagesisthatitmayincreasetheriskofmultiplepregnancy.Multiplepregnancyisacommoncomplicationofovulationinduction,anditcanincreasetheriskofpretermlabor,lowbirthweight,andothercomplications.TheuseofGnRHantagonistsforovulationinductioncanincreasetheriskofmultiplepregnancycomparedtoothermethodsofovulationinduction.

AnotherpotentialdisadvantageofusingGnRHantagonistsforovulationinductionisthatitmayhavelong-termeffectsonfertility.WhilethereiscurrentlynoevidencetosuggestthattheuseofGnRHantagonistsforovulationinductionhasanylong-termeffectsonfertility,furtherstudiesareneededtoconfirmthis.

Inconclusion,theuseofGnRHantagonistsforovulationinductionisaneffectiveandsafetreatmentoptionforpatientswithinfertility.Whiletherearesomepotentialdisadvantagestothistreatment,thesecanbemitigatedbycarefulmonitoringandmanagementofpatients.Furtherstudiesareneededtoinvestigatethelong-termeffectsofGnRHantagonisttherapyonfertility,aswellastoidentifythepatientswhoaremostlikelytobenefitfromthistreatmentLookingforward,thereareseveralareasofresearchthatcanbeexploredinrelationtotheuseofGnRHantagonistsforovulationinduction.Firstly,morestudiesneedtobeconductedtodiscoverwhichpatientsaremostsuitableforthistreatmentoption.Thisincludesidentifyingvarioussubgroupsofwomenbasedontheirage,bodymassindex(BMI),andotherclinicalfactors,aswellasdetermininghowthesefactorsmightimpacttheeffectivenessofthetherapy.

Secondly,moreresearchisneededtoexplorethelong-termeffectsofGnRHantagonisttherapyonfertilityoutcomes,includingtheincidenceofmultiplepregnancies,complicationsduringpregnancyandchildbirth,andtheoverallhealthoftheoffspring.Bycloselymonitoringpatientswhohaveundergonethisformofovulationinductionandfollowingupwiththemforseveralyearsafterthetreatment,researcherscangathervaluabledataonthesafetyandefficacyofthisapproach.

Thirdly,researcherscancontinuetoinvestigatewaystoimprovetheoverallsuccessrateofGnRHantagonisttherapybyexploringnewdosingregimens,improvingthetimingofadministration,andinvestigatingtheuseofothermedicationsorsupplementstoboostovulationinductionsuccess.

Finally,thereisscopetoexploretheuseofGnRHantagonistsincombinationwithotherfertilitytreatments,suchasinvitrofertilization(IVF).Bycombiningthesetreatments,itmaybepossibletoachievehigherpregnancyratesandimprovetheoverallreproductiveoutcomesofpatientswithinfertility.

Inconclusion,theuseofGnRHantagonistsforovulationinductionisavaluabletreatment