胎内受精/細胞内精子注射のための卵巣刺激を受ける低応答者におけるゴナドトロフィン用量:体系的なレビューとメタ解析
Kokkoni I Kiose1, Efstratios M Kolibianakis1, Eleni E Kolibianaki1
1Unit for Human Reproduction, First Department of Obstetrics and Gynecology, Aristotle University, Thessaloniki, Greece.
Minerva obstetrics and gynecology
|September 3, 2025
まとめ
卵巣刺激を受けた低卵巣反応の女性では,高めの開始用量のゴナドトロピンは生育率を改善しません. これらの患者に対する治療決定を明確にするために,証拠はまだ不十分です.
科学分野:
- 生殖内分泌学
- 不妊症 の 治療
- 臨床試験の分析
背景:
- 低卵巣反応は助産生殖技術における一般的な課題です.
- 卵巣刺激プロトコルの最適化は,卵巣貯蔵量が減少した患者の治療結果を改善するために不可欠です.
研究 の 目的:
- 卵巣反応が低いと予測される患者で,より高い対低めの初期用量の有効性を評価する.
- ゴナドトロピンの投与が,生殖能力に関する重要な結果に与える影響を決定する.
主な方法:
- ランダム化制御試験 (RCT) の体系的レビューとメタ解析が行われました.
- 2024年12月までの文献検索には,主要なデータベースと臨床試験の登録が含まれていました.
- 2次評価は妊娠率と卵子の産出率でした.
主要な成果:
- 2262人の患者を含む6つのRCTを分析した.
- 生産率,臨床妊娠率,進行中の妊娠率において,有意な差異は認められなかった.
- 初期用量より低い使用可能な胚の数が観察されました.
結論:
- 期待される低応答の生児率を改善するために,高濃度のゴナドトロピンの開始用量を支持する現在の証拠は不十分です.
- この患者群の最適のゴナドトロピンの投与戦略を確立するには,さらなる研究が必要である.
関連する概念動画
In Vitro Fertilization
385
In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
385
Infertility in Females
401
Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
Endometriosis, a condition characterized by abnormal growth of...
Endometriosis, a condition characterized by abnormal growth of...
401
Hormonal Control of the Ovarian Cycle
2.7K
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
2.7K
Dosage Regimen: Fixed Dose
2.0K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
2.0K
Rational Dosage Regimen: Maintenance Dose and Loading Dose
4.4K
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
4.4K
Insulin: Dosing Regimen and Adverse Effects
253
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
253


