对于不同波西顿子组的GnRH激动剂/对抗剂协议的有效性 较差的卵巢响应者
Jelena Havrljenko1,2, Vesna Kopitovic1, Aleksandra Trninic Pjevic1
1Ferona Fertility Clinic, Sarplaninska 19, 21000 Novi Sad, Serbia.
Journal of clinical medicine
|March 27, 2025
概括
波赛顿分类有助于为辅助生殖技术 (ART) 的反应较差者量身定制卵巢刺激协议. 虽然GnRH抗剂有利于某些群体,而GnRH激动剂有利于其他群体,但活产率仍然低于正常反应者.
科学领域:
- 生殖内分泌学和不孕不育问题
- 辅助生殖技术 (ART) 是一种助孕技术.
- 卵巢刺激方案 卵巢刺激方案
背景情况:
- 响应较差的患者在ART中构成重大挑战,卵巢响应不足与受孕率降低有关.
- 波赛顿分类精细化了响应不良的识别,区分预期和意外的低卵巢响应,以进行个性化治疗.
- 在ART中比较GnRH激动剂和抗剂协议对于优化特定患者子组的结果至关重要.
研究的目的:
- 为了比较根据波赛顿标准分类的低响应者中的GnRH激动剂与对抗剂协议的临床结果.
- 为了确定不同波西顿群体最有效的卵巢刺激方案.
- 评估卵巢刺激策略对接受ART的妇女活产率的影响.
主要方法:
- 对1323名预后较低的妇女进行了回顾性研究,这些妇女使用波塞顿标准进行了分类.
- 对比GnRH激动剂和GnRH抗剂的卵巢刺激方案.
- 包括一个正常响应者的对照组进行结果比较.
主要成果:
- 在波塞顿1b组中,GnRH-对抗剂协议显示出了优势.
- 在波塞顿4组中,GnRH-agonist协议更有效.
- 在不良反应者中,两种方案之间没有观察到活产或流产率的显著差异.
结论:
- 波赛顿分类患者的活产率明显低于正常响应者,无论使用哪种方案.
- 卵细胞产量,成熟度,质量和患者年龄是成功ART结局的关键决定因素.
- 对新的卵巢刺激策略的进一步研究是必要的,以改善卵细胞的生产和活产率.
相关概念视频
01:30Hormonal Control of the Ovarian Cycle
358
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...
358
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
169
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
169
01:22Hormonal Regulation of the Menstrual Cycle
241
The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
241
01:25Drug-Receptor Interaction: Agonist
2.3K
Agonists are drugs that interact with specific receptors in the body to produce a biological response. When an agonist binds to a receptor, it activates or enhances the receptor's function, leading to physiological effects. The interaction between agonist drugs and receptors is crucial for their therapeutic action in various medical treatments.
Agonists can bind to receptors in different ways. Some agonists bind directly to the receptor's active site, mimicking the endogenous...
Agonists can bind to receptors in different ways. Some agonists bind directly to the receptor's active site, mimicking the endogenous...
2.3K
02:07Oogenesis
63.3K
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...
63.3K
01:27Ovarian Cycle
874
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...
874