意想不到的不良反应者与随后的刺激周期中意想不到的正常反应者,一个队列研究
Kai-Lun Hu1, Mingmei Lin1, Zheng Wang2
1Center for Reproductive Medicine, Peking University Third Hospital, No.49 Huayuan North Road, Haidian District, Beijing 100191, China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing 100191, China.
European journal of obstetrics, gynecology, and reproductive biology
|December 6, 2025
概括
在第一周期有意想不到的卵巢不良反应 (POR) 的女性在第二周期有较低的POR风险,相比那些有意想不到的正常反应的女性. 这一发现有助于预测生育治疗的未来结果.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精 (IVF)
- 预测卵巢反应的预测
背景情况:
- 在随后的试管婴儿周期中预测卵巢反应对于优化治疗策略至关重要.
- 了解意想不到的反应可以改进患者的咨询和管理.
- 以前的卵巢不良反应 (POR) 是辅助生殖技术的一个重大问题.
研究的目的:
- 为了比较第二次试管婴儿刺激周期中卵巢反应差 (POR) 的可能性,在意外的POR和第一次周期中意外的正常反应的女性之间进行试管婴儿刺激周期.
- 在连续的刺激周期中确定影响卵巢反应的因素.
主要方法:
- 一项回顾性队列研究,涉及9,408名女性,他们在一个中心接受了第一和第二次试管婴儿刺激周期.
- 根据预测 (AMH/AFC) 和实际的卵巢反应,参与者被分为四组.
- 主要结局是第二个周期的POR (卵细胞数 < 4),以年龄,BMI和不孕因素进行调整.
主要成果:
- 在第一周期出现意想不到的POR的女性在第二周期出现POR的风险显著降低 (13%对24%,调整后OR:0.52).
- 这些女性的胚胎移植率也较低 (12%对21%),生化,临床和多胎妊娠率较高.
- 对年轻女性 (≤35岁) 的敏感性分析证实了这些稳定的发现.
结论:
- 在第一个试管婴儿周期中,意外的卵巢不良反应与随后周期中不良反应的风险降低有关.
- 这表明,最初意想不到的POR可能并不总是预测未来的不良结果,为一些患者提供了更乐观的前景.
- 这些发现可以为个性化试管婴儿治疗计划和患者的期望提供信息.
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