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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.

DOI:10.1007/s10815-011-9575-z
PMID:21556889
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3158256/
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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Controversies in IVM.体外受精的争议。
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2
The effect of low dose human chorionic gonadotropin on follicular response and oocyte maturation in PCOS patients undergoing IVF cycles: a randomized clinical trial of efficacy and safety.低剂量人绒毛膜促性腺激素对多囊卵巢综合征患者体外受精周期中卵泡反应和卵母细胞成熟的影响:一项疗效和安全性的随机临床试验。
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Turk J Obstet Gynecol. 2018 Sep;15(3):141-146. doi: 10.4274/tjod.22804. Epub 2018 Sep 3.
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本文引用的文献

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Laboratory and embryological aspects of hCG-primed in vitro maturation cycles for patients with polycystic ovaries.多囊卵巢患者人绒毛膜促性腺激素(hCG)触发的体外成熟周期的实验室和胚胎学方面。
Hum Reprod Update. 2010 Nov-Dec;16(6):675-89. doi: 10.1093/humupd/dmq014. Epub 2010 May 26.
2
THE COMPARATIVE BEHAVIOR OF MAMMALIAN EGGS IN VIVO AND IN VITRO : I. THE ACTIVATION OF OVARIAN EGGS.哺乳动物卵在体內和体外的比较行为:I. 卵巢卵的激活。
J Exp Med. 1935 Oct 31;62(5):665-75. doi: 10.1084/jem.62.5.665.
3
Effect of different gonadotrophin priming on IVM of oocytes from women with normal ovaries: a prospective randomized study.不同促性腺激素预处理对正常卵巢妇女卵母细胞 IVM 的影响:一项前瞻性随机研究。
Reprod Biomed Online. 2009 Sep;19(3):343-51. doi: 10.1016/s1472-6483(10)60168-x.
4
Predictive factors in in-vitro maturation in unstimulated women with normal ovaries.正常卵巢未刺激女性体外成熟的预测因素。
Reprod Biomed Online. 2009 Feb;18(2):251-61. doi: 10.1016/s1472-6483(10)60263-5.
5
Comparison of low-dose human menopausal gonadotropin and micronized 17beta-estradiol supplementation in in vitro maturation cycles with thin endometrial lining.低剂量人绝经期促性腺激素与微粒化17β-雌二醇补充剂在子宫内膜薄的体外成熟周期中的比较。
Fertil Steril. 2009 Sep;92(3):907-912. doi: 10.1016/j.fertnstert.2008.07.1750. Epub 2008 Oct 30.
6
Comparison of in-vitro maturation cycles with and without in-vivo matured oocytes retrieved.对获取了体内成熟卵母细胞和未获取体内成熟卵母细胞的体外成熟周期进行比较。
Reprod Biomed Online. 2008 Jul;17(1):59-67. doi: 10.1016/s1472-6483(10)60294-5.
7
In vitro maturation and fertilization of oocytes from unstimulated ovaries in infertile women with polycystic ovary syndrome.多囊卵巢综合征不孕女性未受刺激卵巢卵母细胞的体外成熟与受精
Fertil Steril. 2009 Jun;91(6):2568-71. doi: 10.1016/j.fertnstert.2008.03.059. Epub 2008 Jun 24.
8
A 38 h interval between hCG priming and oocyte retrieval increases in vivo and in vitro oocyte maturation rate in programmed IVM cycles.在程序化体外成熟(IVM)周期中,人绒毛膜促性腺激素(hCG)预处理与卵母细胞采集之间间隔38小时可提高体内和体外卵母细胞成熟率。
Hum Reprod. 2008 Sep;23(9):2010-6. doi: 10.1093/humrep/den210. Epub 2008 Jun 12.
9
Selection of patients for natural cycle in vitro fertilization combined with in vitro maturation of immature oocytes.自然周期体外受精联合未成熟卵母细胞体外成熟患者的选择。
Fertil Steril. 2009 Apr;91(4):1050-5. doi: 10.1016/j.fertnstert.2008.01.066. Epub 2008 Mar 25.
10
In vitro maturation of oocytes collected from unstimulated ovaries for oocyte donation.从未受刺激的卵巢收集的用于卵子捐赠的卵母细胞的体外成熟。
Fertil Steril. 2007 Jul;88(1):62-7. doi: 10.1016/j.fertnstert.2006.11.087. Epub 2007 Mar 6.