预测超响应者的辅助生殖技术的临床结果:叙述性综述
Isabel Saavedra-Rocha1,2, Michel DE Vos3,4
1Brussels IVF, University Hospital of Brussels, Brussels, Belgium.
Minerva obstetrics and gynecology
|September 5, 2025
概括
优化辅助生殖技术 (ART) 的超响应包括平衡卵细胞产量与安全性. 每个周期的15-19个卵细胞的目标提供了最佳的活产率,同时最大限度地降低了卵巢过度刺激综合征的风险.
科学领域:
- 生殖内分泌学
- 辅助生殖技术 (ART)
- 卵巢刺激管理
背景情况:
- 由于卵巢过度刺激综合征 (OHSS) 的风险与卵细胞产量增加的好处,在ART中预测过度反应者的管理具有挑战性.
- 目前的文献强调需要精确的策略来平衡这些相互竞争的因素.
研究的目的:
- 对治疗高反应症患者的当前进展进行审查.
- 探索适应的刺激方案, 排卵触发,冷保存, 和个性化策略.
- 讨论体外卵子成熟作为一种新兴的替代方案.
主要方法:
- 进行了全面的文献审查.
- 文章的选择是基于相关性,严谨性和对治疗高反应者的贡献.
- 综合了关键发现,以提供证据和新出现的趋势.
主要成果:
- 对于平衡活产率和并发症风险,转向每周期15-19个目标卵细胞检索范围似乎是最佳的.
- 精确预测卵巢反应,特别是在抗穆勒激素 (AMH) 升高的患者中,仍然是一个挑战.
- 考虑到年龄,BMI和卵巢储备标记的个性化方案是非常重要的,因为反应的可变性.
结论:
- 个性化的ART方案对于高反应者至关重要, 整合了量身定制的淋巴激素剂量和高级冷保存.
- 在某些特定情况下,卵细胞的体外成熟有改善活产率的潜力.
- 未来的研究应该专注于改进预测算法,探索遗传因素,并加强以患者为中心的安全性和结果.
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