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在高响应者中触发卵细胞成熟:关于1217个连续周期的报告
Maria Gonçalves1,2, Mariana Cunha3, José Teixeira da Silva3
1Laboratory of Cell Biology, Department of Microscopy, ICBAS-Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
Reproduction & fertility
|October 7, 2025
概括
在高反应率的试管婴儿患者中,使用性腺激素释放激素激动剂 (GnRHa) 触发器与质hCG用于新鲜胚胎移植,产生与hCG触发器相似的结果. 所有胚胎的冷有效地防止了卵巢过度刺激综合征 (OHSS) 的住院治疗.
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
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 卵巢过度刺激综合征 (OHSS) 是辅助生殖的一个重大风险,特别是在高响应者.
- 目前的协议涉及谨慎的触发器选择和质阶段支持,以减轻OHSS风险.
- 人类胆固醇激素 (hCG) 和胆固醇释放激素激动剂 (GnRHa) 之间的选择会触发影响结果和OHSS发生率.
研究的目的:
- 在接受新鲜胚胎移植 (ET) 和冷解胚胎移植 (FET) 的高响应患者中,比较hCG与GnRHa触发的疗效和安全性.
- 根据触发型和胚胎目的地 (新鲜的ET与结) 来评估胚胎,临床和新生儿结局,以及OHSS率.
主要方法:
- 在一个高响应人群中分析了683个新鲜的ET周期和534个FET周期.
- 根据触发型 (hCG或GnRHa) 和胚胎目的地 (新鲜ET或冷全部[FA]) 将周期分为五组.
- 对OHSS的比较率,卵细胞检索,胚胎细胞形成,植入,临床怀孕和新生儿的结果.
主要成果:
- 严重的OHSS仅在新鲜的ET周期中发生;GnRHa触发显示了一个不显著的较低率.
- 结所有循环导致更高的卵细胞检索率和胚胎细胞率.
- 在新鲜的ET中,GnRHa触发器与质hCG组显示出更高的植入率和临床怀孕率,尽管在多变量分析后,这些差异并不显著.
结论:
- 在高响应患者中,GnRHa触发器与质hCG用于新鲜的ET提供了与hCG触发器相似的结果.
- 建议对所有有OHSS风险的患者采取结所有策略,以防止严重并发症和住院治疗.
- 这项研究支持个性化治疗策略,考虑到患者的反应和OHSS风险.
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