乳腺期刺激与卵泡期刺激在卵巢反应较差的卵巢中:系统性审查和元分析
Vittorio Agrifoglio1,2, Antonio D'Amato3, Mariano Catello Di Donna4
1Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
概括
乳腺期卵巢刺激 (LPOS) 显示出作为常规卵泡期卵巢刺激 (FPOS) 的替代方案,对于卵巢反应 (POR) 较差的女性来说,具有前景. 虽然结果相似,但LPOS可能会增加胚胎产量,尽管需要更多的研究.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精 (IVF)
背景情况:
- 卵巢反应不良 (POR) 是试管婴儿的一个重大挑战,往往导致周期取消和成功率降低.
- 传统的卵泡期卵巢刺激 (FPOS) 方案对POR患者有局限性.
- 目前正在探索乳腺期卵巢刺激 (LPOS) 作为一种替代策略.
研究的目的:
- 为了比较LPOS与FPOS在辅助生殖技术 (ART) 结果中对POR (博洛尼亚标准) 妇女的疗效.
主要方法:
- 一个系统的审查和对比性研究的元分析评估LPOS与FPOS在接受试管婴儿/ICSI的低响应者.
- 在多个数据库中搜索到2024年7月,独立提取数据和质量评估.
- 随机效应元分析与证据评估的GRADE确定性.
主要成果:
- 纳入了五项研究 (312名患者);LPOS显示了更多的卵细胞和成熟的卵细胞的趋势,显著增加了第三天的胚胎.
- 在临床怀孕,受精,流产或取消率之间没有观察到显著的差异.
- 刺激持续时间在LPOS中较长,但淋巴激素剂量和雌激素水平没有显著差异. 证据的确定性低至非常低.
结论:
- 对于反应较差的患者来说,LPOS似乎是FPOS的可行替代品,具有可比的ART结果和胚胎产量的潜在好处.
- 目前的证据有限,需要进一步的大规模随机对照试验来证实这些初步发现.
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