与双重触发相比,只有GnRH激素激素的触发剂降低了高响应者的卵细胞检索率,而不会影响累积活产率
Yu Wang1, Yu-Chiao Yi1,2, Hwa-Fen Guu1
1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan.
Frontiers in endocrinology
|September 4, 2024
概括
只有GnRH激素激活剂可以降低IVF高响应者的卵巢过度刺激综合征 (OHSS) 风险. 虽然卵细胞检索率较低,但累积活产率仍然与双触发器相当,这使其成为结所有周期的更安全选择.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精 (IVF)
- 卵巢刺激协议 卵巢刺激协议
背景情况:
- 卵巢过度刺激综合征 (OHSS) 是试管婴儿的一个重大风险,特别是在高响应者.
- 双触发协议是常用的,但与OHSS相关.
- 只有GnRH激动剂的触发剂为减轻OHSS风险提供了潜在的替代方案.
研究的目的:
- 在接受试管婴儿的高响应者中,比较GnRH激动剂单触发剂与双触发剂的疗效.
- 评估卵细胞检索率和累积活产率 (LBR).
- 评估安全概况,特别是OHSS的发生率.
主要方法:
- 追溯,匹配的病例控制研究 (2014-2022) 妇女接受试管婴儿/ICSI与GnRH抗剂协议.
- 包括:高反应者 (在触发日的雌激素>3,000 pg/ml).
- 倾向性得分匹配用于平衡GnRH主激素单抗 (116周期) 和双触发 (232周期) 组之间的患者人口统计和基线特征.
主要成果:
- 两组之间年龄,BMI或AMH水平没有显著差异.
- 双触发组显示出较高的卵细胞检索率 (93%对80%,p<0.05).
- 受精率,胚胎细胞形成率和累积LBR是可比的. 重要的是,单抗激素组中没有出现OHSS病例,而双触发组中只有7例.
结论:
- 对于高响应者来说,仅GnRH激动剂的触发剂是可行的选择,可以降低OHSS风险而不影响累积LBR.
- 这种策略对于结所有试管婴儿周期尤其有利.
- 考虑因素包括潜在较低的卵细胞检索率和适合新鲜移植或低LH水平的患者.
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