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对35岁以上女性卵巢反应不佳的受控卵巢过度刺激方案的分析:现实研究
Xiaoyan Duan1, Zhan Li2, Mingming Li3
1Department of Gynaecology and obstetrics, The First People's Hospital of Shangqiu, 292 Kaixuan South Road, Henan, Shangqiu, People's Republic of China. xiaoyanduan123@163.com.
BMC pregnancy and childbirth
|November 23, 2023
概括
对于35岁以上的卵巢反应不佳的女性,修改后的GnRH激动剂协议产生了更多的卵细胞和更高的累积活产率. 这三种受控卵巢过度刺激方案都是改善生育结果的可行选择.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 不孕症治疗 不孕症治疗
- 辅助生殖技术 辅助生殖技术
背景情况:
- 35岁以上女性的卵巢反应不良 (POR) 在成功怀孕方面存在重大挑战.
- 优化受控卵巢过度刺激 (COH) 协议对于改善这一人口群体的结果至关重要.
- 现实世界的数据分析对于评估不同COH策略的有效性至关重要.
研究的目的:
- 确定最佳的受控卵巢过度刺激 (COH) 方案,用于35岁及以上的卵巢反应不良 (POR) 的患者.
- 为了比较改性GnRH激动剂,GnRH抗剂和轻度刺激方案的临床变量和怀孕结果,在这个患者群体中.
主要方法:
- 追溯队列研究分析了4256名患者的数据 (2017年1月 - 2022年11月).
- 患者被分为三组:改性GnRH激动剂 (2116),GnRH对抗剂 (1628),和轻度刺激 (512).
- 对卵细胞产量,可移植胚胎,累积活产率和流产率的比较分析.
主要成果:
- 与GnRH抗剂和轻度刺激方案相比,修改后的GnRH激动剂协议导致卵细胞 (4.02 ± 2.25) 和可移植胚胎 (1.73 ± 1.02) 的数量更高.
- 经过修改的GnRH激动剂协议 (28.50%) 的累积活产率明显高于GnRH对抗剂 (24.94%) 和轻度刺激 (20.51%).
- 轻度刺激方案与更高的流产率 (32.22%) 有关.
结论:
- 对于35岁以上的POR患者,所有三种COH方案 (改性GNRH激动剂,GNRH抗剂,轻度刺激) 都可以使用.
- 修改后的GnRH激动剂协议似乎是那些通过冷解胚胎移植实现更高累积活产率的患者的首选选择.
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