중앙대학교 의과대학 산부인과학교실에서는 1993년 1월부터 6월까지 이전의 hMG/hCG 투여법에서 조기황체화 등에 의해 과배란유도를 중단하였거나 피하주사식 GnRH-a 복합요법에서 임신되지 않았던 환자중에서 임의로 선택한 35명을 실험군으로, 동기간동안 hMG/hCG 투여법을 시행한 28주기를 대조군으로 하여 다음의 결과를 얻었다. 1. 실험군에서 MCD#21일의 혈중 E2농도는 367.7 pg/ml이었으나 COH#3일의 혈중 E2농도는 22.7 pg/ml로 유의하게 감소하였다(p

The most exciting recent development of ovarian stimulation for in vitro fertilization (IVF) has been the widespread use of gonadotropin-releasing hormone analohues(GnRH-a) to prevent premature luteinizing hormone (LH) surges, to increase the average number of oocytes obtained at retrieval and to increase the pregnancy rate. Many different forms of GnRH-a have been approved for use with varied routes of administration. Because intranasal GnRH-a offers a simple and noninvasive route of administration, we performed this study to evaluate the effectiveness of pituitary suppression with intranasal GnRH-a for IVF. Between January and June 1993,35 patients(35 cycles) were recieved combined Nafarelin and hMG treatment. Starting on day 21 of the previous menstrual cycle, Nafarelin was intranasally administered in a dose of 400 micro g twice daily and when pituitary-ovarian suppression had been achieved as indicated by an serum estradiol(E2) of less than 30 pg/ml during Nafarelin administration and then hMG 150-2251 IU/d was administered from COH#3. Control group(28 patients, 28 cycles) were administered by hMG/hCG. The results as follows: 1. Serum E2 level significantly decreased from 267.7+-204.3 pg/ml (Nafarelin#1) to 22.7+-29.3 pg/ml (Nafarelin#15=COH#3) by daily administration of Nafarelin for pituitary suppression(P=14.0 min in diameter) in both groups(12.1+-5.9 vs 9.8+-5.7). 6. There was no difference in the number of retrieved oocytes in both groups(7.2 +- 3.7 vs 8.1+-6.0). 7. Number of cleaved oocytes in study group (5.0+-3.4) were significantly increased than in control group(1.5+-1.2)(p