孕激素培养卵巢刺激:为谁,何时,如何?
1Department of Obstetrics and Gynecology, Koc University School of Medicine, Istanbul, Turkey; ART Fertility Clinics, Dubai, United Arab Emirates.
Reproductive biomedicine online
|December 30, 2023
概括
孕激素辅助卵巢刺激 (PPOS) 为辅助生殖提供了一种具有成本效益的替代方案,其结果与淋巴激素释放激素 (GnRH) 相似. 它对保护生育能力和结所有周期特别有益.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 辅助生殖技术 辅助生殖技术
背景情况:
- 孕激素辅助卵巢刺激 (PPOS) 正在获得辅助生殖技术 (ART) 的吸引力.
- 不同的孕激素在PPOS协议中表现出类似的疗效.
- 与传统的淋巴腺激素释放激素 (GnRH) 类似方案相比,PPOS提供了潜在的优势.
研究的目的:
- 为了比较PPOS的疗效和成本效益与ART中的GnRH模拟协议.
- 为了评估两个刺激方法之间的卵细胞发育潜力和胚胎转移结果.
- 在不同患者群体中评估PPOS的安全性和患者友好性.
主要方法:
- 对比PPOS和GnRH类似方案的现有研究进行系统审查和分析.
- 评估关键绩效指标,包括刺激持续时间,淋巴腺素消耗,卵细胞产量,胚胎细胞积率和怀孕/活产率.
- 考虑药物成本和循环结果的成本效益分析.
主要成果:
- PPOS和GnRH模拟协议显示了类似的卵巢刺激反应,在刺激持续时间和淋巴腺激素使用方面存在微小,临床上无关紧要的差异.
- 通过PPOS获取的卵细胞表现出可比的发育潜力,包括类似的胚胎细胞积率.
- 冷胚胎移植结果,包括正在进行的怀孕/活产率和产科/产周结果,在PPOS和GnRH模拟周期之间是相似的.
- 由于口服和较低的药物成本,PPOS在生育保护和冷周期方面表现出卓越的成本效益.
结论:
- PPOS是辅助生殖的患者友好和经济有效的选择,特别是当不打算移植新鲜胚胎时.
- 虽然由于潜在的额外冷胚胎转移成本,PPOS在新鲜胚胎转移周期中可能成本效益较低,但其总体结果与GnRH模拟协议相美.
- 在不同类型的患者中,PPOS表现出一致的结果,但不包括孕激素受体阳性乳腺癌患者.
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