Luteal-phase ovarian stimulation is feasible for producing competent oocytes in women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment, with optimal pregnancy outcomes in frozen-thawed embryo transfer cycles
Luteal-phase ovarian stimulation is feasible for producing competent oocytes in women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment, with optimal pregnancy outcomes in frozen-thawed embryo transfer cycles
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黄体期卵巢刺激对于接受体外受精/胞浆内单精子注射治疗的女性产生有能力的卵母细胞是可行的，并在冻融胚胎移植周期中获得最佳妊娠结局
DOI：
10.1016/j.fertnstert.2013.09.007
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发表时间：
2014-01-01
影响因子：
6.7
通讯作者：
Shoham, Zeev
中科院分区：
文献类型：
--
作者：
Kuang, Yanping;Hong, Qingqing;Shoham, Zeev
目的：探讨黄体期使用hMG和来曲唑刺激卵巢的可行性，包括卵巢反应和使用冻融胚胎移植的妊娠结局。设计：一项前瞻性队列研究。设置：学术三级医疗中心。患者：242例接受IVF/卵胞浆内单精子注射（ICSI）治疗的女性患者。干预：在自发排卵后开始用hMG 225 IU和来曲唑2.5 mg/d刺激卵巢。当优势卵泡直径达到12 mm时，停止来曲唑给药。当至少3个卵泡直径达到18 mm或1个优势卵泡直径达到20 mm时，用GnRH激动剂100 mg诱导排卵。提取最高质量的胚胎并冷冻保存，以备以后transfer.Main Outcome Measure（s）：测量的主要结局是获得的卵母细胞数量。次要结果是临床妊娠率，持续妊娠率和冷冻胚胎移植（FET）cycles. Results（s）后的植入率：在参加这项研究的242名妇女中，所有参与者都成功地产生了卵母细胞，227名妇女有最高质量的胚胎冷冻保存。平均获得13.1个卵母细胞，平均产生4.8个最高质量的胚胎。此外，在刺激周期中，没有病例出现过早的LH激增或中度/重度卵巢过度刺激综合征。在FET中，临床妊娠率、继续妊娠率和种植率分别为55.46%（127/229）、48.91%（112/229）和40.37%（174/431）。在研究中的所有妊娠中，68例导致活产，44例正在进行中。结论：黄体期卵巢刺激对于接受IVF/ICSI治疗的女性产生合格的卵母细胞/胚胎是可行的，在FET周期中具有最佳的妊娠结局。（Fertil Steril（R）2014; 101：105-11。(C)美国生殖医学会（American Society for Reproductive Medicine）
Objective: To explore the feasibility of luteal-phase ovarian stimulation using hMG and letrozole in terms of ovarian response and pregnancy outcome using frozen-thawed embryo transfer.Design: A prospective cohort study.Setting: Academic tertiary-care medical center.Patient(s): Two hundred forty-two female patients undergoing IVF/intracytoplasmic sperm injection (ICSI) treatment.Intervention(s): Ovarian stimulation was initiated with hMG 225 IU and letrozole 2.5 mg daily after spontaneous ovulation. Letrozole administration was stopped when the dominant follicles reached diameters of 12 mm. Ovulation was induced with a GnRH agonist 100 mg when at least three follicles reached diameters of 18 mm or one dominant follicle reached 20 mm. The highest quality embryos were extracted and cryopreserved for later transfer.Main Outcome Measure(s): The primary outcome measured was the number of oocytes retrieved. Secondary outcomes were the clinical pregnancy rate, ongoing pregnancy rate, and implantation rate after frozen embryo transfer (FET) cycles.Result(s): Of the 242 women enrolled in the study, all participants succeeded in producing oocytes and 227 women had highest-quality embryos to cryopreserve. The average number of oocytes retrieved was 13.1, producing an average of 4.8 highest quality embryos. Moreover, no cases experienced a premature LH surge or moderate/severe ovarian hyperstimulation syndrome during the stimulation cycles. In FETs, the clinical pregnancy rate, ongoing pregnancy rate, and implantation rate were 55.46% (127/229), 48.91% (112/229), and 40.37% (174/431), respectively. Of all the pregnancies in the study, 68 resulted in live births and 44 were ongoing.Conclusion(s): Luteal-phase ovarian stimulation is feasible for producing competent oocytes/embryos in women undergoing IVF/ICSI treatments, with optimal pregnancy outcomes in FET cycles. (Fertil Steril (R) 2014; 101: 105-11. (C) 2014 by American Society for Reproductive Medicine.)