在POSEIDON组3和4接受辅助生殖技术周期的低响应患者中,卵泡的最佳前端尺寸
Nilüfer Akgün1, Yavuz Emre Şükür2,3, Batuhan Aslan2,4
1Department of Obstetrics and Gynecology, University of Health Sciences Türkiye, Etlik Zübeyde Hanım Women's Health, Training and Research Hospital, Ankara, Türkiye.
Journal of the Turkish German Gynecological Association
|September 3, 2025
概括
在辅助生殖技术 (ART) 周期中,优化人类胆管激素 (hCG) 触发时间对于反应较差的患者至关重要. 在主要卵泡大小为16. 5 - 17毫米时触发可改善POSEIDON组3和4的卵细胞检索和活产率.
科学领域:
- 生殖内分泌学
- 辅助生殖技术
- 卵巢刺激方案
背景情况:
- 包含个性化卵细胞数量的患者导向策略 (POSEIDON) 3和4组代表辅助生殖技术 (ART) 具有挑战性的群体.
- 在ART中通常使用性激素释放激素 (GnRH) 抗剂,以防止早期的性激素 (LH) 激增.
- 优化人类胆性腺激素 (hCG) 触发时间对于最大限度地提高卵细胞产量和质量至关重要.
研究的目的:
- 评估hCG触发的卵泡大小与活产率之间的关系.
- 在POSEIDON组3和4中确定最大限度地提高活产结果的最佳卵泡大小.
- 评估主要卵泡大小对GnRH抗剂循环中的卵细胞获取和质量的影响.
主要方法:
- 在POSEIDON第三组和第四组 (20至42岁) 接受GnRH抗剂方案的细胞内精子注射 (ICSI) 的患者进行了回顾性队列研究.
- 结果分析,包括检测到的卵细胞,第二阶段 (MII) 卵细胞,MII卵细胞比例和卵泡卵细胞指数 (FOI).
- 在hCG触发时不同主要毛囊大小类别的结果的比较,基于早产卵的分类.
主要成果:
- 在16- 17毫米的最大毛囊大小与毛囊卵细胞指数 (FOI) 和MII/ antral毛囊数量比率相关.
- 多变量逻辑回归确定了领先的卵泡大小 (OR 1. 361, p=0. 001) 作为早产的独立预测因子.
- 在早排卵组中观察到平均领先毛囊大小为19. 8±2. 4毫米,而在非早排卵组中则为18. 7±2毫米 (p< 0. 001).
结论:
- 基于主要卵泡大小的个性化hCG触发可以优化预期反应较差的卵细胞的检索.
- 当主要卵泡大小在16. 5和17毫米之间时,触发可能会防止过早排卵和低于最佳的MII产量.
- 在接受ART的POSEIDON组3和4患者中,这种方法可能有助于实现最佳的循环结果.
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