UCSF Women's Health Clinical Research Center & UCSF Center for Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco, California, USA.
Semin Reprod Med. 2010 Nov;28(6):475-85. doi: 10.1055/s-0030-1265674. Epub 2010 Nov 16.
This article reviews the biological plausibility and evidence for the use of a low triggering dose of human chorionic gonadotropin (hCG) in the prevention of ovarian hyperstimulation syndrome (OHSS). A systematic search of the literature revealed very little published data for or against the use of low-dose hCG in the prevention of OHSS after assisted reproductive technology. We have had success at avoiding OHSS as a result of gentle stimulation and low-dose sliding scale hCG trigger based on estradiol (E₂) levels. We therefore present the biological plausibility for such an approach by reviewing the relationship between OHSS, vascular endothelial growth factor, and hCG; the physiology of hCG; the relationship between risk of OHSS and E₂ at trigger; and the physiology of alternative methods of triggering such as recombinant luteinizing hormone and gonadotropin-releasing hormone agonist. We also present the results of a quasi-experimental before and after study of the sliding scale protocol for hCG trigger dose in in vitro fertilization with or without intracytoplasmic sperm injection cycles.
这篇文章综述了使用低触发剂量人绒毛膜促性腺激素（hCG）预防卵巢过度刺激综合征（OHSS）的生物学合理性和证据。系统的文献检索发现，关于辅助生殖技术后使用低剂量 hCG 预防 OHSS 的研究数据很少。我们通过温和刺激和基于雌二醇（E₂）水平的低剂量滑动 hCG 触发来成功避免了 OHSS。因此，我们通过回顾 OHSS、血管内皮生长因子和 hCG 之间的关系、hCG 的生理学、触发时 OHSS 风险与 E₂ 之间的关系以及替代触发方法（如重组促黄体激素和促性腺激素释放激素激动剂）的生理学来为这种方法提供生物学合理性。我们还介绍了体外受精中有无胞浆内精子注射周期的 hCG 触发剂量滑动比例方案的准实验前后研究结果。
