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三个周期轻度刺激体外受精后的累积妊娠率及根据亚生育诊断的结果:一项多中心队列研究。

Cumulative pregnancy rates after three cycles of minimal stimulation IVF and results according to subfertility diagnosis: a multicentre cohort study.

作者信息

Pelinck M J, Vogel N E A, Hoek A, Simons A H M, Arts E G J M, Mochtar M H, Beemsterboer S, Hondelink M N, Heineman M J

机构信息

Section of Reproductive Medicine, Department of Obstetrics and Gynaecology, University Medical Center Groningen, The Netherlands.

出版信息

Hum Reprod. 2006 Sep;21(9):2375-83. doi: 10.1093/humrep/del192. Epub 2006 Jun 3.

Abstract

BACKGROUND

In minimal stimulation IVF, treatment is aimed at using the single oocyte that spontaneously develops to dominance. To prevent untimely ovulation, a GnRH antagonist is administered in the late follicular phase of the natural cycle together with recombinant FSH for substitution. Owing to the lack of ovarian stimulation, minimal stimulation IVF is a low-risk and patient-friendly treatment. In this study, effectiveness of minimal stimulation IVF was studied.

METHODS

In this prospective multicentre cohort study, minimal stimulation IVF was offered to 350 patients. All indications for conventional IVF were included. Main outcome measures were pregnancy rates per cycle and cumulative pregnancy rates after three cycles.

RESULTS

A total of 336 patients completed 844 cycles (2.5 per patient). The overall ongoing pregnancy rate per started cycle was 8.3% [95% confidence interval (CI) 6.4-10.2%]. The cumulative ongoing pregnancy rate after up to three cycles was 20.8% (95% CI 16.4-25.3%) per patient. No differences were found according to indication for IVF.

CONCLUSIONS

Minimal stimulation IVF seems suitable for all indications studied. Pregnancy rates are encouraging. Owing to the low-risk and patient-friendly nature of this protocol, it seems a feasible treatment option for patients requiring IVF.

摘要

背景

在微刺激体外受精中,治疗旨在利用自发发育至优势状态的单个卵母细胞。为防止过早排卵,在自然周期的卵泡晚期给予促性腺激素释放激素(GnRH)拮抗剂,并联合重组促卵泡生成素(FSH)进行替代治疗。由于缺乏卵巢刺激,微刺激体外受精是一种低风险且对患者友好的治疗方法。在本研究中,对微刺激体外受精的有效性进行了研究。

方法

在这项前瞻性多中心队列研究中,为350例患者提供了微刺激体外受精治疗。纳入了所有常规体外受精的适应症。主要观察指标为每个周期的妊娠率和三个周期后的累积妊娠率。

结果

共有336例患者完成了844个周期(每位患者2.5个周期)。每个起始周期的总体持续妊娠率为8.3%[95%置信区间(CI)6.4 - 10.2%]。每位患者在最多三个周期后的累积持续妊娠率为20.8%(95%CI 16.4 - 25.3%)。根据体外受精的适应症未发现差异。

结论

微刺激体外受精似乎适用于所研究的所有适应症。妊娠率令人鼓舞。由于该方案具有低风险和对患者友好的特点,对于需要体外受精的患者来说,它似乎是一种可行的治疗选择。

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