克洛米芬酸在卵巢刺激期间在卵巢储备减少的患者:降低成本,减少注射负担,防止过早排卵的方法
Rachel S Mandelbaum1,2, Samuel Melville3, Aaron Masjedi4
1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California Keck School of Medicine, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA. rachel.mandelbaum@med.usc.edu.
Journal of assisted reproduction and genetics
|February 1, 2025
概括
在卵巢储备减少 (DOR) 的妇女体外受精 (IVF) 的长时间克洛米芬酸盐 (CC) 协议产生与标准协议相匹配的成熟卵细胞. 这种方法也大大降低了过早排卵的风险.
科学领域:
- 生殖内分泌学和不孕不育问题
- 辅助生殖技术 (ART) 是一种辅助生殖技术.
背景情况:
- 克洛米芬酸盐 (CC) 常用于早期试管婴儿刺激,以释放FSH.
- 如果继续使用,CC的抗雌激素特性可能会防止过早排卵.
- 标准协议通常将CC与GnRH对抗剂结合在一起.
研究的目的:
- 为了评估"长期CC"协议,在整个试管婴儿周期中使用CC而不是GnRH抗剂.
- 为了比较长 CC 协议和标准 5 天 CC + GnRH 抗剂协议之间的试管婴儿结果.
- 评估结果,特别是在患者的卵巢储备减少 (DOR) 接受试管婴儿高剂量淋巴激素.
主要方法:
- 基于CC的试管婴儿周期的回顾性队列研究 (9/2020-9/2022),不包括轻度刺激协议.
- 长CC组:在整个循环中使用CC而没有GNRH抗剂.
- CC + GnRH抗体组:在前5天进行CC,然后在14mm毛囊大小时启动GnRH抗体.
- 主要结局:成熟卵细胞的产量.
主要成果:
- 长时间CC (中位数5) 和5天CC + GnRH抗剂 (中位数4.5) 组之间的成熟卵细胞产量没有显著差异 (P=0.922).
- 每个AFC的MII卵细胞也没有显著差异 (0.69与0.56,P=0.16).
- 早期排卵发生在长时间CC组 (0.3%) 与5天CC + GnRH抗组 (3.0%) 相比显著少 (P=0.019).
结论:
- 长时间的CC协议是DOR患者体外受精的有效和患者友好的替代方案.
- 该方案表明,与标准方案相比,卵细胞产量不低于标准方案.
- 长时间的CC协议观察到过早排卵率的显著降低.
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