促性腺激素释放激素激动剂触发卵母细胞成熟失败：原因及其处理。
Failure of GnRH agonist-triggered oocyte maturation: its cause and management.
机构信息
Asada Ladies Clinic, RENAK 5F, Matsushincho 1-4, Kasugai, Aichi, 486-0931, Japan.
出版信息
J Assist Reprod Genet. 2013 Apr;30(4):581-5. doi: 10.1007/s10815-013-9966-4. Epub 2013 Mar 15.
Abstract
OBJECTIVE
In the present study we investigated the cause of GnRHa's failure to trigger oocyte maturation and present an effective rescue protocol for use when failure occurs.
DESIGN
Case reports.
SETTING
One in vitro fertilization (IVF) center.
PATIENT(S): Eight cases of failure of GnRH agonist (GnRHa)-triggered oocyte maturation and one case of GnRHa successfully triggered oocyte maturation, despite a weak response in the LH-RH test.
MAIN OUTCOME MEASURE(S): All cases were successfully rescued by re-triggering maturation using HCG, with seven of the eight patients achieving ongoing pregnancy and successful delivery.
RESULT(S): In three patients the cause of the oocyte maturation failure was likely temporal or continuous severe down-regulation of the hypothalamus-pituitary-axis, the cause was unknown in the other five patients.
CONCLUSION(S): In cases where GnRHa fails to trigger oocyte maturation, a rescue protocol entailing re-triggering with HCG can produce successful outcomes.
摘要
目的
本研究旨在探讨 GnRH 激动剂（GnRHa）诱发卵母细胞成熟失败的原因，并提出一种有效的补救方案。
设计
病例报告。
地点
一个体外受精（IVF）中心。
患者
8 例 GnRHa 触发卵母细胞成熟失败，1 例 GnRHa 触发卵母细胞成熟成功，尽管 LH-RH 试验反应较弱。
主要观察指标
所有病例均通过 HCG 再次触发成熟而成功获救，其中 7 例患者获得持续妊娠并成功分娩。
结果
3 例患者卵母细胞成熟失败的原因可能是下丘脑-垂体轴的时间性或持续严重下调，另外 5 例患者原因不明。
结论
在 GnRHa 未能触发卵母细胞成熟的情况下，采用 HCG 再次触发的补救方案可以获得成功的结果。
相似文献
1
Failure of GnRH agonist-triggered oocyte maturation: its cause and management.促性腺激素释放激素激动剂触发卵母细胞成熟失败：原因及其处理。
J Assist Reprod Genet. 2013 Apr;30(4):581-5. doi: 10.1007/s10815-013-9966-4. Epub 2013 Mar 15.
2
Assessing the adequacy of gonadotropin-releasing hormone agonist leuprolide to trigger oocyte maturation and management of inadequate response.评估促性腺激素释放激素激动剂亮丙瑞林触发卵母细胞成熟的充分性和处理反应不足。
Fertil Steril. 2016 Oct;106(5):1093-1100.e3. doi: 10.1016/j.fertnstert.2016.06.013. Epub 2016 Jun 21.
3
GnRH agonist versus HCG triggering in different IVF/ICSI cycles of same patients: a retrospective study.促性腺激素释放激素激动剂与绒毛膜促性腺激素触发在不同患者的体外受精/卵胞浆内单精子注射周期中的应用：一项回顾性研究。
J Obstet Gynaecol. 2020 Aug;40(6):837-842. doi: 10.1080/01443615.2019.1674262. Epub 2019 Dec 3.
4
A simplified universal approach to COH protocol for IVF: ultrashort flare GnRH-agonist/GnRH-antagonist protocol with tailored mode and timing of final follicular maturation.一种简化的体外受精促排卵方案通用方法：采用定制的最终卵泡成熟模式和时间的超短激动剂/拮抗剂联合方案。
J Ovarian Res. 2015 Nov 4;8:69. doi: 10.1186/s13048-015-0198-3.
5
Predicting successful induction of oocyte maturation after gonadotropin-releasing hormone agonist (GnRHa) trigger.预测促性腺激素释放激素激动剂（GnRHa）触发后卵母细胞成熟的成功诱导。
Hum Reprod. 2013 Jan;28(1):152-9. doi: 10.1093/humrep/des361. Epub 2012 Oct 17.
6
Maternal and neonatal outcomes after gonadotropin-releasing hormone agonist trigger for final oocyte maturation in patients undergoing in vitro fertilization.促性腺激素释放激素激动剂触发卵子成熟在体外受精患者中的母婴结局。
Fertil Steril. 2014 Sep;102(3):753-8. doi: 10.1016/j.fertnstert.2014.05.030. Epub 2014 Jun 19.
7
Self-Detection of the LH Surge in Urine After GnRH Agonist Trigger in IVF-How to Minimize Failure to Retrieve Oocytes.促性腺激素释放激素激动剂扳机后尿 LH 峰的自我检测——如何最大程度减少取卵失败。
Front Endocrinol (Lausanne). 2020 Apr 21;11:221. doi: 10.3389/fendo.2020.00221. eCollection 2020.
8
Gonadotropin-releasing hormone agonist versus HCG for oocyte triggering in antagonist assisted reproductive technology cycles.在拮抗剂辅助生殖技术周期中，促性腺激素释放激素激动剂与绒毛膜促性腺激素用于触发卵母细胞的比较。
Cochrane Database Syst Rev. 2011 Jan 19(1):CD008046. doi: 10.1002/14651858.CD008046.pub3.
9
Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates.使用促性腺激素释放激素激动剂和标准剂量人绒毛膜促性腺激素的双重触发以提高卵母细胞成熟率。
Fertil Steril. 2014 Aug;102(2):405-9. doi: 10.1016/j.fertnstert.2014.04.028. Epub 2014 May 17.
10
Gonadotropin-releasing hormone agonist versus HCG for oocyte triggering in antagonist assisted reproductive technology cycles.在拮抗剂辅助生殖技术周期中，促性腺激素释放激素激动剂与绒毛膜促性腺激素用于触发排卵的比较。
Cochrane Database Syst Rev. 2010 Nov 10(11):CD008046. doi: 10.1002/14651858.CD008046.pub2.
引用本文的文献
1
Follicular challenge test to predict suboptimal response to gonadotropin releasing hormone agonist trigger in elective oocyte cryopreservation cycles.卵泡刺激试验预测促性腺激素释放激素激动剂扳机在选择性卵母细胞冷冻保存周期中反应不佳。
Sci Rep. 2024 Mar 14;14(1):6204. doi: 10.1038/s41598-024-56418-2.
2
Low LH level does not indicate poor IVF cycle outcomes with GnRh-a single trigger: a retrospective analysis.低黄体生成素（LH）水平并不表示 GnRH-a 扳机时 IVF 周期结局不佳：一项回顾性分析。
BMC Pregnancy Childbirth. 2022 Dec 20;22(1):951. doi: 10.1186/s12884-022-05251-4.
3
HCG Trigger After Failed GnRH Agonist Trigger Resulted in Two Consecutive Live Births: A Case Report.促性腺激素释放激素激动剂扳机失败后使用人绒毛膜促性腺激素扳机获得连续两次活产：一例报告
Front Reprod Health. 2021 Oct 27;3:764299. doi: 10.3389/frph.2021.764299. eCollection 2021.
4
Prediction, assessment, and management of suboptimal GnRH agonist trigger: a systematic review.预测、评估和管理 GnRH 激动剂扳机时机不当：系统评价。
J Assist Reprod Genet. 2022 Feb;39(2):291-303. doi: 10.1007/s10815-021-02359-y. Epub 2022 Mar 19.
5
Gonadotropin levels at the start of ovarian stimulation predict normal fertilization after hCG re-trigger in GnRH antagonist cycles.在GnRH拮抗剂周期中，卵巢刺激开始时的促性腺激素水平可预测hCG再次触发后的正常受精情况。
Reprod Med Biol. 2020 Dec 18;20(1):96-107. doi: 10.1002/rmb2.12359. eCollection 2021 Jan.
6
Controlled ovarian hyperstimulation for fertility preservation in women with breast cancer: Practical issues.乳腺癌女性生育力保存的控制性卵巢过度刺激：实际问题
Clin Exp Reprod Med. 2021 Mar;48(1):1-10. doi: 10.5653/cerm.2020.03594. Epub 2020 Nov 2.
本文引用的文献
1
Trophectoderm morphology significantly affects the rates of ongoing pregnancy and miscarriage in frozen-thawed single-blastocyst transfer cycle in vitro fertilization.滋养层形态显著影响体外受精冷冻-解冻单囊胚移植周期的持续妊娠和流产率。
Fertil Steril. 2012 Aug;98(2):361-7. doi: 10.1016/j.fertnstert.2012.05.014. Epub 2012 Jun 6.
2
Circulating luteinizing hormone level after triggering oocyte maturation with GnRH agonist may predict oocyte yield in flexible GnRH antagonist protocol.用 GnRH 激动剂触发卵母细胞成熟后循环黄体生成素水平可能预测灵活 GnRH 拮抗剂方案中的卵母细胞产量。
Hum Reprod. 2012 May;27(5):1351-6. doi: 10.1093/humrep/des049. Epub 2012 Mar 14.
3
Empty follicle syndrome after GnRHa triggering versus hCG triggering in COS.促性腺激素释放激素激动剂触发与绒毛膜促性腺激素触发在控制性卵巢刺激中对空卵泡综合征的影响。
J Assist Reprod Genet. 2012 Mar;29(3):249-53. doi: 10.1007/s10815-011-9704-8. Epub 2012 Jan 12.
4
Failure of triggering oocyte maturation with a GnRH agonist in polycystic ovary syndrome: two case reports.多囊卵巢综合征中使用促性腺激素释放激素激动剂触发卵母细胞成熟失败：两例病例报告。
Eur J Obstet Gynecol Reprod Biol. 2011 Aug;157(2):239-40. doi: 10.1016/j.ejogrb.2011.03.002. Epub 2011 Apr 7.
5
Preventing ovarian hyperstimulation syndrome: guidance for the clinician.预防卵巢过度刺激综合征：临床医生指南。
Fertil Steril. 2010 Jul;94(2):389-400. doi: 10.1016/j.fertnstert.2010.03.028. Epub 2010 Apr 22.
6
Symposium: Update on prediction and management of OHSS. Prevention of OHSS.研讨会：卵巢过度刺激综合征（OHSS）预测与管理的最新进展。OHSS的预防。
Reprod Biomed Online. 2009 Jul;19(1):33-42. doi: 10.1016/s1472-6483(10)60043-0.
7
Empty follicle syndrome: the reality of a controversial syndrome, a systematic review.空卵泡综合征：一种有争议综合征的实际情况，一项系统评价
Fertil Steril. 2008 Sep;90(3):691-8. doi: 10.1016/j.fertnstert.2007.07.1312. Epub 2007 Nov 26.
8
GnRH agonist to induce oocyte maturation during IVF in patients at high risk of OHSS.在有卵巢过度刺激综合征高风险的患者中，使用促性腺激素释放激素激动剂在体外受精期间诱导卵母细胞成熟。
Reprod Biomed Online. 2006 Nov;13(5):639-44. doi: 10.1016/s1472-6483(10)60653-0.
9
GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study.促性腺激素释放激素激动剂（布舍瑞林）或人绒毛膜促性腺激素用于促性腺激素释放激素拮抗剂体外受精/卵胞浆内单精子注射周期的排卵诱导：一项前瞻性随机研究。
Hum Reprod. 2005 May;20(5):1213-20. doi: 10.1093/humrep/deh765. Epub 2005 Mar 10.
10
Early timed follicular aspiration prevents severe ovarian hyperstimulation syndrome.
J Assist Reprod Genet. 1996 Apr;13(4):282-6. doi: 10.1007/BF02070139.
Zotero 插件