Praxi Provita Infertility Center, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1814-9.
Ovarian stimulation is an integral procedure in assisted reproduction treatment. It is achieved by the administration of exogenous gonadotropins to increase follicular recruitment and oocyte yield. Optimization of ovarian stimulation is an essential prerequisite for the success of IVF treatment.
This study aimed to evaluate the effect of a combined stimulation protocol of human FSH and recombinant FSH, simultaneously administered, on oocyte and embryo quality and clinical outcome.
In a prospective randomized study 197 infertile patients with a history of previous IVF failures for at least 3-5 attempts, were enrolled for an in vitro fertilization treatment. All patients had a standard down-regulation with GnRH analog and were then stimulated with FSH. The patients were matched into three groups: group A (no = 66) received human FSH combined with recombinant FSH in equal doses, simultaneously administered; group B (no = 67) received human FSH alone and group C (no = 64) received recombinant FSH alone.
There were significantly higher pregnancy (p < 0.04) and implantation rates (p < 0.03) in favor of group A (hFSH/rFSH) compared to groups B (hFSH) and C (rFSH). A significant increase in the proportion of mature metaphase II oocytes (p < 0.002) and grade 1 embryos (p < 0.03) was observed in group A with respect to group B and C. Significantly higher delivery rate (p < 0.01) was achieved in group A compared to groups B and C. No significant differences were observed between groups regarding miscarriage rate and risk of ovarian hyperstimulation syndrome.
The results show that the combination of human and recombinant FSH for ovarian stimulation may produce a positive effect on follicular development as it improve oocyte quality, embryo development, and ultimately clinical outcome.
卵巢刺激是辅助生殖治疗中的一个重要程序。通过给予外源性促性腺激素来增加卵泡募集和卵母细胞产量来实现。卵巢刺激的优化是体外受精治疗成功的基本前提。
本研究旨在评估同时给予人卵泡刺激素 (hFSH) 和重组卵泡刺激素 (rFSH) 的联合刺激方案对卵母细胞和胚胎质量以及临床结局的影响。
在一项前瞻性随机研究中，招募了 197 名有至少 3-5 次体外受精失败史的不孕患者进行体外受精治疗。所有患者均接受 GnRH 类似物的标准下调，然后接受 FSH 刺激。患者分为三组：A 组（n=66）接受等量的 hFSH 和 rFSH 联合治疗，同时给予；B 组（n=67）接受 hFSH 单独治疗，C 组（n=64）接受 rFSH 单独治疗。
与 B 组（hFSH）和 C 组（rFSH）相比，A 组（hFSH/rFSH）的妊娠率（p<0.04）和着床率（p<0.03）显著更高。与 B 组和 C 组相比，A 组的成熟中期 II 卵母细胞比例（p<0.002）和 1 级胚胎比例（p<0.03）显著增加。与 B 组和 C 组相比，A 组的分娩率（p<0.01）显著更高。三组之间的流产率和卵巢过度刺激综合征风险无显著差异。
结果表明，hFSH 和 rFSH 的联合用于卵巢刺激可能对卵泡发育产生积极影响，从而提高卵母细胞质量、胚胎发育，并最终改善临床结局。
