评估重复的卵巢刺激周期对非最佳反应患者的卵泡发育的影响
Nir Kugelman1,2, Alyssa Hochberg1,3, Maria Hincapie1
1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
概括
重复的卵巢刺激显著改善了女性的卵泡发育,而女性的反应不足. 随后的循环,特别是经过调整的方案或更高的淋巴激素剂量,对于大多数患者来说,会产生更好的结果.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 不孕症治疗 不孕症治疗
- 卵巢刺激协议 卵巢刺激协议
背景情况:
- 不理想的卵泡发育可能导致取消体外受精 (IVF) 周期.
- 了解影响后续周期毛囊生长的因素对于优化治疗成功至关重要.
研究的目的:
- 为了评估重复的卵巢刺激是否会在取消了次优周期后增强卵泡发育.
- 在第二次刺激尝试中确定改善毛囊反应的预测因素.
主要方法:
- 一个回顾性队列研究,对162名患者进行了两次连续的卵巢刺激周期.
- 由于≤3个毛囊≥14毫米,最初的周期被取消.
- 主要结局:在排卵触发之前的毛囊数≥14毫米.
主要成果:
- 第二个周期显示显著更多的毛囊≥14毫米 (平均4.2比1.5,P<0.001).
- 77.2%的患者表现出更好的毛囊发育.
- 协议修改或增加淋巴激素剂量与更大的毛囊增加有关.
结论:
- 重复的卵巢刺激通常会在低于最佳的初始周期后改善卵泡发育.
- 卵巢储备减少 (低AMH或AFC) 的患者改善的可能性较低.
- 对刺激方案的个性化调整可以提高治疗效率.
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