最小刺激协议对植入前遗传查的影响
Gokalp Oner1,2, Enes Karaman3, Ferhan Elmali4
1Department of Obstetrics and Gynecology, Faculty of Medicine, Istanbul Aydin University, 34295 Istanbul, Turkey.
Journal of clinical medicine
|June 26, 2025
概括
对于接受生育治疗的妇女来说,最小刺激方案在与高剂量方案相比,在euploid胚胎和活产方面提供了相似的成功率,其附加的好处是成本更低,患者舒适度更高. 这一发现对于优化晚年孕产妇患者治疗策略至关重要.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 辅助生殖技术 辅助生殖技术
- 遗传学 遗传学 是一个
背景情况:
- 植入前遗传查 (PGS) 有助于在细胞内质精子注射 (ICSI) 中选择胚胎.
- 晚产期妇女 (AMA) 经历染色体正常性下降,需要优化卵巢刺激.
- 高剂量的淋巴激素通常用于改善AMA患者的卵泡反应.
研究的目的:
- 为了比较最小与高剂量卵巢刺激协议的有效性.
- 为了评估经过ICSI的38-45岁妇女的euploid胚胎率,临床怀孕率和活产率.
- 为了确定高剂量刺激是否在AMA患者中提供更好的结果.
主要方法:
- 这是一项前性研究,涉及198名年龄在38-45岁的女性,她们正在接受ICSI.
- 两个组进行了比较:最小刺激 (克洛米芬酸盐+人更年期性淋巴激素) 和高刺激 (高剂量淋巴激素).
- 排除标准包括严重的男性因子,子宫内膜异位症和绝对输卵管因子;结果使用t测试或曼·惠特尼U测试进行分析.
主要成果:
- 高剂量组产生了更多的检索和第II阶段转移卵细胞 (p=0.009,p=0.003).
- 欧胚胎发育率没有显著差异 (35.4%与37.4%,p=0.768).
- 临床怀孕 (67.6%对69.4%),妊娠囊 (58.8%对58.3%) 和活产率 (47.1%对50.0%) 在两组之间是可比的 (p>0.999,p=0.995).
结论:
- 这是第一项前性研究,对AMA患者的euploid胚胎,怀孕和活产率的最小和高剂量刺激方案进行比较.
- 在这个人群中,最小刺激方案显示出与高剂量方案相比的生殖结果.
- 最小刺激在成本效益和患者舒适性方面具有优势,使其成为AMA患者的可行替代方案.
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