体外受精的争议。
Controversies in IVM.
机构信息
MUHC Reproductive Center, Department of Obstetrics and Gynecology, Royal Victoria Hospital, Montreal, Quebec, Canada, H3A 1A1.
出版信息
J Assist Reprod Genet. 2011 Jun;28(6):525-30. doi: 10.1007/s10815-011-9575-z. Epub 2011 May 10.
Abstract
PURPOSE
To explore four areas of controversy: the benefits of gonadotropin priming, benefits and timing of hCG trigger as well as the ideal protocols for endometrial preparation and luteal support.
METHODS
A literature review was performed to explore the current evidence
RESULTS
Current evidence suggests that Gonadotropin priming in combination with hCG prior to collection benefits patients with normal ovaries. In PCOS patients 10,000 IU hCG 38 h before retrieval increases the total number and rate of oocyte maturation. Gonadotropin priming may also benefit PCOS patients. The ideal timing of hCG trigger appears to be when the leading follicle is 10-12 mm. Sparse data exists regarding luteal support protocols.
CONCLUSIONS
There is still a need for well-designed studies to establish ideal methods for oocyte priming, timing of retrieval, endometrial preparation and luteal support. Further studies must incorporate both clinical and basic science principles of ovarian, follicular and endometrial physiology.
摘要
目的
探讨四个争议领域：促性腺激素预处理的益处、hCG 扳机的益处和时机，以及子宫内膜准备和黄体支持的理想方案。
方法
进行文献回顾以探索现有证据。
结果
现有证据表明，在取卵前使用促性腺激素联合 hCG 预处理对正常卵巢患者有益。在 PCOS 患者中，取卵前 38 小时使用 10,000IU hCG 可增加卵母细胞成熟的总数和速率。促性腺激素预处理也可能对 PCOS 患者有益。hCG 扳机的理想时机似乎是当主导卵泡为 10-12mm 时。关于黄体支持方案的数据很少。
结论
仍需要精心设计的研究来确定卵母细胞预处理、取卵时机、子宫内膜准备和黄体支持的理想方法。进一步的研究必须结合卵巢、卵泡和子宫内膜生理学的临床和基础科学原则。
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