相关实验视频
Updated: Jul 1, 2025

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Human Egg Maturity Assessment and Its Clinical Application
Published on: August 19, 2019
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在激发GnRH激动剂后,低卵细胞产量和卵细胞不成熟的危险因素
S Gambini1, C Sonigo2, G Robin3
1Assistance Publique-Hôpitaux de Paris (APHP), Université Sorbonne Paris Nord, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Bondy, France.
Human reproduction (Oxford, England)
|March 7, 2024
概括
下卵巢储备和LH水平是GnRH激动剂触发后卵细胞检索不良的危险因素. 较高的BMI和AMH水平增加了卵细胞不成熟的风险,影响了生育治疗.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精过程中受精.
- 卵巢刺激 卵巢刺激
背景情况:
- 淋巴激素释放激素激动剂 (GnRHa) 越来越多地用于辅助生殖技术中的排卵触发.
- 在GnRHa触发后,可能会出现低于最佳的反应,包括卵细胞恢复和不成熟的情况,因此需要识别风险因素.
- 现有的研究已经探索了影响GnRHa触发器有效性的各种因素,但对预测标记的共识仍然难以达成.
研究的目的:
- 为了确定与GnRHa排卵触发后低卵细胞恢复率 (ORR) 相关的潜在风险因素.
- 调查在GnRHa触发后导致卵细胞不成熟 (低卵细胞成熟率,OMR) 的风险因素.
- 为优化在生育治疗中的排卵触发策略提供见解.
主要方法:
- 一个双中心的回顾性队列研究,包括1747名年龄在18-43岁之间的患者,接受GnRHa触发 (triptorelin0.2 mg) 进行ICSI或卵细胞冷保存.
- ORR定义为采集的卵细胞/卵泡>12毫米;OMR定义为成熟的卵细胞/采集的卵细胞.
- 采用多变量逻辑回归分析来确定ORR和OMR差的显著风险因素.
主要成果:
- 触发后12小时,较低的初始 antral 毛囊数量和LH 水平与较差的ORR相关.
- 较高的身体质量指数 (BMI) 和抗穆勒尔激素 (AMH) 水平与较高的卵细胞不成熟风险 (OMR <75%) 有关.
- 研究人员发现,抗原性前期治疗可以降低卵细胞不成熟的风险.
结论:
- 患有较高BMI和/或低卵巢储备的患者可能受益于替代性排卵触发策略,以避免ORR差,平衡OHSS风险.
- 触发后12小时低的LH水平表明ORR差的风险,建议考虑hCG重新触发.
- 识别这些风险因素可以帮助临床医生个性化排卵触发协议,以改善试管婴儿周期的结果.
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