Flexibility in starting ovarian stimulation at different phases of the menstrual cycle for treatment of infertile women with the use of in vitro fertilization or intracytoplasmic sperm injection
Flexibility in starting ovarian stimulation at different phases of the menstrual cycle for treatment of infertile women with the use of in vitro fertilization or intracytoplasmic sperm injection
复制标题
灵活地在月经周期的不同阶段开始卵巢刺激，通过体外受精或胞浆内单精子注射治疗不孕女性
DOI：
10.1016/j.fertnstert.2016.04.006
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发表时间：
2016-08-01
影响因子：
6.7
通讯作者：
Kuang, Yanping
中科院分区：
文献类型：
--
作者：
Qin, Ningxin;Chen, Qiuju;Kuang, Yanping
目的：研究在接受辅助生殖治疗的不孕妇女月经周期的任何阶段开始控制性卵巢刺激的灵活性。设计：回顾性队列研究。设置：学术三级医疗中心。患者：共150例接受体外受精（IVF）或卵胞浆内单精子注射（ICSI）治疗的不孕患者。90名妇女还接受了冷冻胚胎移植（FET）程序。干预措施：根据卵巢刺激开始时的月经周期阶段，确定了三组患者，即：常规组（卵巢刺激开始于卵泡早期），卵泡晚期组和黄体期组。当观察到优势卵泡时，使用GnRH激动剂和hCG触发最终卵母细胞成熟。在所有三个组中，活的胚胎冷冻保存为后续transfer.Main结果Measures（S）：主要结果：成熟卵母细胞的数量检索。次要结局：结果：常规组、卵泡晚期组和黄体期组获得的成熟卵母细胞的平均数无差异（分别为5.7 ± 3.6、5.2 ± 3.7和5.2 ± 3.9）。同样，每个取出的卵母细胞的活胚胎率也没有观察到显着差异（37.9%、38.5%和43.6%），临床妊娠率（41.5%、45.5%和38.9%），以及植入率结论：三种促排卵方案的促排卵效果相同，但其促排卵效果不明显，三种促排卵方案的促排卵率分别为30.7%、30.2%和27.1%。这些结果表明，卵巢刺激可以在月经周期的任何一天开始。(C)2016年，美国生殖医学会（American Society for Reproductive Medicine）
Objective: To investigate flexibility in starting controlled ovarian stimulation at any phase of the menstrual cycle in infertile women undergoing treatment with assisted reproduction.Design: Retrospective cohort study.Setting: Academic tertiary-care medical center.Patient(s): At total of 150 infertile patients undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. Ninety of the women also underwent frozen embryo transfer (FET) procedures.Intervention(s): Depending on the phase of the menstrual cycle when ovarian stimulation was started, three groups of patients were identified, namely: conventional group (ovarian stimulation started in the early follicular phase), late follicular phase group, and luteal phase group. When dominant follicles were observed, final oocyte maturation was triggered with the use of GnRH agonist and hCG. In all three groups, viable embryos were cryopreserved for subsequent transfer.Main Outcome Measure(s): Primary outcome: number of mature oocytes retrieved. Secondary outcomes: fertilization rate, viable embryo rate per oocyte retrieved, cancellation rate, and clinical pregnancy outcomes from FET cycles.Results(s): There were no differences in the mean number of mature oocytes retrieved in the conventional group, late follicular phase group, and luteal phase group (5.7 +/- 3.6, 5.2 0 +/- 3.7, and 5.2 +/- 3.9, respectively). Similarly, no significant differences were observed in the viable embryo rate per oocyte retrieved (37.9%, 38.5%, and 43.6%), clinical pregnancy rates (41.5%, 45.5%, and 38.9%), and implantation rates (30.7%, 30.2%, and 27.1%) in the three groups.Conclusion(s): All three ovarian stimulation protocols were observed to be equally effective. These results demonstrate that ovarian stimulation can be commenced on any day of the menstrual cycle. (C) 2016 by American Society for Reproductive Medicine.