在以患者为导向的策略中对卵巢刺激,包括个性化卵细胞数-4类别;对手与短激动剂协议的对抗者
Tarek K Al-Hussaini1, Ahmed Aboelfadle Mohamed1, Ayman Askar1
1Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Asyut, Egypt.
Journal of human reproductive sciences
|December 4, 2023
概括
对于预期IVF反应较差的妇女 (POSEIDON-4),GNRH-对抗剂和GNRH-激动剂的短期方案产生类似的活产率. 这项研究将这些协议与POSEIDON-4组的细胞体内精子注射 (ICSI) 周期进行了比较.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精 (IVF)
背景情况:
- 波赛顿分类系统对预期卵巢对常规试管婴儿刺激反应较差的患者进行了分层分类.
- 优化对IVF中反应不良患者的管理仍然是活跃的研究领域.
研究的目的:
- 为了比较GnRH-antagonist与GnRH-agonist在细胞内注射精子 (ICSI) 循环中的短期协议的疗效,特别针对POSEIDON-4患者组.
- 在这个具有挑战性的患者队列中,评估两个刺激方案之间的活产率和其他关键结果.
主要方法:
- 在第三级不孕症病房进行了190次新鲜的ICSI周期的回顾性分析 (2016年1月 - 2020年12月).
- 纳入标准:POSEIDON-4分类 (AFC<5和AMH<1.2 ng/ml的35岁以上的患者).
- 较量GnRH-对抗剂和GnRH-激动剂短协议,与统计分析包括t测试,曼·惠特尼,奇方,和多变量逻辑回归.
主要成果:
- 在新鲜胚胎转移率,由于反应不佳而导致的周期取消或对抗体和激动体组之间的优质胚胎发育方面没有观察到显著差异.
- 发现了可比的总性腺激素剂量,卵细胞检索和成熟率以及临床怀孕率.
- 活产率在两组之间是相似的 (8.9%对10.8%,P=0.659),在多变量调整后,协议类型对活产率没有显著的影响.
结论:
- GnRH-对抗剂和GnRH-激动剂的简短方案表明,在受试管婴儿/ICSI治疗的POSEIDON-4类别的患者中,怀孕和活产的结果相似.
- 这些协议之间的选择可能不会显著影响这个特定群体中响应较差的人的成功率.
相关概念视频
02:07Oogenesis
63.7K
In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
63.7K
01:30Hormonal Control of the Ovarian Cycle
527
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...
527
01:27Ovarian Cycle
1.3K
The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
1.3K