基于POSEIDON组3和4分类的低响应者的超低剂量和非常低剂量的Lupron下调方案
Zachary W Walker1,2, Andrea Lanes3,4, Serene S Srouji3,4
1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Brigham & Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. zwalker1@bwh.harvard.edu.
Journal of assisted reproduction and genetics
|June 16, 2023
概括
超低剂量卢普朗 (ULDL) 和非常低剂量卢普朗 (VLDL) 方案显示,在体外受精时反应不佳的患者的结果相似. 这些稀释的Lupron协议是POSEIDON组3和4患者的有效替代方案.
科学领域:
- 生殖内分泌学和不孕不育问题
- 辅助生殖技术 辅助生殖技术
- 临床试验设计和分析.
背景情况:
- 在体外受精 (IVF) 中反应不佳的患者往往有减少的卵细胞产量和较低的活产率.
- 波赛顿分类确定了特定的患者群体 (第三和第四组) 的反应不佳.
- 为不良反应者优化刺激协议对于提高试管婴儿成功率至关重要.
研究的目的:
- 评估超低剂量Lupron (ULDL) 和非常低剂量Lupron (VLDL) 协议是否能与其他响应较差的协议产生可比的循环结果.
- 评估ULDL和VLDL协议在POSEIDON分类组3和4中的有效性.
主要方法:
- 回顾性队列研究,包括2012-2021年在一个学术中心进行的3601次试管婴儿周期.
- 分析了分为POSEIDON组3 (年龄35,AMH <1.2 ng/mL) 或4 (年龄≥35,AMH <1.2 ng/mL) 的患者.
- 比较ULDL,VLDL,微发光,雌醇原始/对抗剂,对抗剂和最小刺激协议的结果;主要结果:成熟卵细胞 (MII);次要结果:活产率 (LBR).
主要成果:
- 在POSEIDON组3中,ULDL和VLDL协议与其他协议相比,产生了相当数量的MII卵细胞和活产.
- 在POSEIDON组4中,ULDL和VLDL协议显示MII卵细胞的百分比比较高,而不是微或最小刺激协议.
- 在ULDL/VLDL和其他协议之间没有观察到活产率的显著差异.
结论:
- 稀释路普朗下调协议 (ULDL和VLDL) 显示出与已建立的响应较差的协议相比的有效性.
- ULDL和VLDL协议代表了可行和有效的治疗选择,用于POSEIDON组3和4中响应较差的患者.
- 这些发现支持使用稀释的Lupron协议来优化特定响应较差人群的试管婴儿结果.
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