Castelo Branco Altina, Achour-Frydman Nelly, Kadoch Jacques, Fanchin Renato, Tachdjian Gerard, Frydman René
Department of Obstetrics and Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart, France.
Fertil Steril. 2005 Oct;84(4):875-80. doi: 10.1016/j.fertnstert.2005.03.067.
To investigate whether seminatural cycle is a reasonable management for ovarian aging patients.
Prospective study.
ART Unit, Clamart, France.
PATIENT(S): Seventy-five women, 158 cycles.
INTERVENTION(S): Infertile women who presented with ovarian aging (defined as low ovarian reserve and characterized by cycle day 3 high FSH, high E2, and/or low inhibin B and/or previous cycle cancellations due to poor ovarian response to COH) were studied. Patients were offered up to three cycles. Treatment was scheduled as follows. From cycle day 8 onward the selection of the dominant follicle was monitored by ultrasound and hormonal measurements. When the dominant follicle appeared, patients received GnRH antagonist and, thereafter, hMG to support further follicular development.
MAIN OUTCOME MEASURE(S): Implantation rate and clinical pregnancy.
RESULT(S): Twenty-eight of 158 cycles were cancelled (17.7%). Oocyte pickups were performed in 119 (75.3%) cycles, 91 (57.6%) mature oocytes were retrieved, and 67 (42.4%) embryos transferred. Nineteen clinical pregnancies were obtained; the cumulative pregnancy rate per patient, after 3 cycles, was 35.2%.
CONCLUSION(S): Use of a seminatural cycle is a reasonable management for patients with ovarian aging who have ovulatory menstrual cycles. It achieves a high implantation rate (28.3%).
探讨半自然周期对于卵巢衰老患者是否是一种合理的治疗方案。
前瞻性研究。
法国克拉马尔的辅助生殖科。
75名女性，共158个周期。
研究对象为患有卵巢衰老的不孕女性（定义为卵巢储备功能低下，表现为月经周期第3天FSH水平高、E2水平高和/或抑制素B水平低，和/或既往因对控制性卵巢刺激反应差而取消周期）。患者最多可接受三个周期的治疗。治疗安排如下。从月经周期第8天起，通过超声和激素测定监测优势卵泡的选择。当优势卵泡出现时，患者接受GnRH拮抗剂，此后接受hMG以支持卵泡进一步发育。
种植率和临床妊娠率。
158个周期中有28个（17.7%）被取消。119个（75.3%）周期进行了取卵，获得91个（57.6%）成熟卵子，移植67个（42.4%）胚胎。获得19例临床妊娠；每位患者在3个周期后的累积妊娠率为35.2%。
对于有排卵性月经周期的卵巢衰老患者，采用半自然周期是一种合理的治疗方案。其种植率较高（28.3%）。
