用r-hFSH:r-hLH进行卵巢刺激:对胚胎形态动力学数据的描述性分析
Edson Borges1,2, Daniela Paes Almeida Ferreira Braga1,3, Assumpto Iaconelli1,2
1Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.
概括
与r-hFSH单独治疗相比,Pergoveris是复合人类卵泡刺激激素和黄素化激素 (r-hFSH:r-LH) 的组合,改善了晚期孕妇的胚胎发育和怀孕结果. 这一发现表明生育治疗的潜在好处.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 胚胎学 胚胎学
- 在体外受精过程中受精.
背景情况:
- 控制卵巢刺激 (COS) 协议对于体外受精 (IVF) 非常重要.
- 先进的孕产妇年龄 (AMA) 在实现成功的试管婴儿结果方面提出了独特的挑战.
- 将不同的COS协议进行比较对于优化AMA患者治疗至关重要.
研究的目的:
- 在接受试管婴儿的AMA妇女中,比较Pergoveris (r-hFSH:r-hLH) 和GONAL-f (r-hFSH单疗法) 之间的胚胎形态动力学参数和临床结果.
- 评估这些COS协议对胚胎发育和植入率的影响.
- 在卵细胞产量,怀孕和流产率方面评估每个方案的安全性和有效性.
主要方法:
- 在AMA患者中对136个ICSI周期进行了回顾性,非干预性描述性研究.
- 根据COS协议对患者进行分组:GONAL-f (n=64) 或Pergoveris (n=72).
- 分析了胚胎形态动力学和ICSI结果,包括时间到爆发 (tB).
主要成果:
- 珀戈维里斯组的胚胎达到爆发速度更快 (109.3小时 vs 112.6小时),具有较早的形态动力学里程碑和较低的多核化率.
- 佩戈维里斯周期产生了更多的卵子和成熟的卵子,植入率,临床和持续怀孕率更高.
- 尽管使用更高的淋巴激素剂量和更长时间的刺激,但与GONAL-f相比,Pergoveris的流产率和OHSS率较低.
结论:
- 在AMA患者中,r-hFSH:r-LH组合 (Pergoveris) 证明了加速的胚胎形态动力学和优异的植入和怀孕结果.
- 对于接受试管婴儿的晚年孕产妇,Pergoveris可能比r-hFSH单疗更有优势.
- 建议进行进一步的前性研究,以验证这些发现并确认Pergoveris的好处.
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