自然周期中的卵巢反应,最小刺激和与抗穆勒激素水平相关的常规试管婴儿方案 - 一项多中心研究
I Magaton1, A Arni1, L von Arnim2
1Division of Gynaecological Endocrinology and Reproductive Medicine, University Women s Hospital, Inselspital, Friedbühlstrasse 19, 3010 Bern, Switzerland.
概括
在各种体外受精 (IVF) 方案中,抗穆勒激素 (AMH) 水平有效预测卵巢反应. 以AMH为基础的个性化最小刺激方案可以优化卵细胞检索,特别是对于卵巢储备减少的女性.
科学领域:
- 生殖内分泌学
- 在体外受精 (IVF)
- 卵巢刺激方案
背景情况:
- 传统的试管婴儿 (cIVF) 补充了其他方案,如自然循环 (NC-IVF) 和最小刺激 (Min stim-IVF) 以进行个性化治疗.
- 这些方案为试管婴儿和卵子冷保存提供了量身定制的方法.
- 开发卵巢反应预测模型对于优化个性化试管婴儿策略至关重要.
研究的目的:
- 开发一个卵巢反应的预测模型.
- 评估不同刺激方案和抗穆勒激素 (AMH) 水平对卵巢反应的影响.
- 根据患者个体特征来指导选择适当的刺激方案.
主要方法:
- 一个回顾性队列研究,涉及1504次NC-IVF,1287次Min stim-IVF和2048次cIVF周期.
- 最小刺激方案使用口服化合物 (克洛米芬酸盐,芳香酶抑制剂) +/-低剂量淋巴激素.
- 负二项回归模型分析了协议和AMH对AMH类别 (<1,1-2,≥2ng/ml) 的卵细胞和胚胎产量的影响.
主要成果:
- 在IVF方案中,AMH是卵细胞产量的重要预测因子.
- 含有淋巴腺素的治疗方案增加了卵细胞数量,但单独服用口服化合物并没有增加.
- 刺激方案对卵细胞产量的影响在AMH水平较高时被放大,显示AMH≥2ng/ ml的患者与AMH<1ng/ ml的患者之间的方案之间的差异更为明显.
结论:
- AMH水平可以实现最小刺激方案的个性化.
- 基于AMH预测的卵巢反应可以指导特定刺激策略的选择.
- 这种方法特别有利于优化卵巢储量较低的患者的治疗结果.
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