Badawy Ahmed, Wageah Alaa, El Gharib Mohamed, Osman Ezz Eldin
Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt.
J Reprod Infertil. 2012 Jul;13(3):124-30.
The ovarian stimulation of poor responders still remains a challenging task for clinicians. There are numerous strategies that have been suggested to improve the outcome in poor responders but there is still no one pituitary down-regulation protocol that best suits all women with such condition. Traditional GnRH agonist flare and long luteal phase protocols do not appear to be advantageous. Reduction of GnRH agonist doses, "stop" protocols, and microdose GnRH agonist flare regimes all appear to improve outcomes, although the proportional benefit of one approach over another has not been convincingly established. GnRH antagonists improve outcomes in this patient population, although, in general, pregnancy rates appear to be lower in comparison to microdose GnRH agonist flare regimes.
对于反应不良者的卵巢刺激，对临床医生来说仍然是一项具有挑战性的任务。已经提出了许多策略来改善反应不良者的治疗结果，但仍然没有一种垂体降调节方案最适合所有患有这种情况的女性。传统的GnRH激动剂激发方案和长黄体期方案似乎并无优势。降低GnRH激动剂剂量、“停止”方案以及微剂量GnRH激动剂激发方案似乎都能改善治疗结果，尽管一种方法相对于另一种方法的相对益处尚未得到令人信服的确立。GnRH拮抗剂可改善该患者群体的治疗结果，不过总体而言，与微剂量GnRH激动剂激发方案相比，妊娠率似乎较低。
