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在早产卵巢缺陷和男性因素不孕症中个性化体外受精协议:一个案例系列

Agus Heriyanto¹, Dian Tjahyadi¹, Anita Rachmawati¹

¹Department Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.

The American journal of case reports

|August 3, 2025

概括

本案例系列探讨了与男性因素不孕症相关的原发性卵巢缺陷 (POI) 的管理,展示了个性化治疗和辅助疗法可以产生生物怀孕.

科学领域:

生殖内分泌学生殖内分泌学
不孕症管理不孕症管理
案例系列研究案例系列研究

背景情况:

关于原发性卵巢缺陷 (POI) 与严重的男性因素不孕症相结合的文献有限.
这项研究评估了四名男性不孕症POI患者的临床决策和结果.
研究了诸如生长激素 (GH) 和脱水氨 (DHEA) 等辅助疗法.

研究的目的:

介绍一系列关于在POI和男性因子不孕症患者中管理不孕症的案例.
为了说明这种复杂的患者群体的临床决策和治疗结果.
评估辅助疗法在改善生殖结果方面的有效性.

主要方法:

四名患有低抗米勒尔激素 (AMH) 和男性不孕症的患者接受了细胞体内精子注射 (ICSI).
治疗方案各不相同,包括高剂量淋巴激素 (FSH,LH,GH) 和最小刺激 (克洛米芬酸盐,FSH).
使用了辅助疗法 (GH,DHEA,西尔德纳菲尔,西菲林) 和子宫内膜制剂.

主要成果:

两个周期导致植入失败.
一个周期实现了生化妊娠 (β-hCG 9.22 mIU/mL).
一个循环导致临床怀孕 (25%) 经过子宫内膜受体增强后.

结论:

管理男性因子不孕症的POI需要个性化的卵巢刺激和精子优化.
辅助疗法和子宫内膜制备可以改善结果,观察到50%的生物反应率.
对于这一群体,进一步研究卵巢再生和先进的精子选择是有必要的.

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