Ubaldi Filippo, Vaiarelli Alberto, D'Anna Rosario, Rienzi Laura
GENERA, Centre for Reproductive Medicine, Valle Giulia Clinic, Rome, Italy.
Department of Gynecological/Obstetrical Sciences and Reproductive Medicine, University Hospital "G. Martino," Messina, Italy.
Biomed Res Int. 2014;2014:352098. doi: 10.1155/2014/352098. Epub 2014 Jul 20.
Despite the fact that in the last two decades an enormous number of papers on the topic of poor ovarian response have been published in the literature, so far it has been impossible to identify any efficient treatment to improve the ovarian response and the clinical outcome of this group of patients. The incidence of poor ovarian responders among infertile women has been estimated at 9-24% but according to recent reviews, it seems to have slightly increased. The limitation in quantifying the incidence of these patients among the infertile population is due to the difficulty of a clear definition in literature. A recent paper by the Bologna ESHRE working group on poor ovarian response has been the first real attempt to find a common definition. Current literature proposes new risk factors which could be the cause of a reduction in ovarian reserve, which also includes genetic factors. This represents the first necessary step towards finding applicable solutions for these patients. To date, there is a substantial lack of literature that identifies an ideal protocol for these patients. The use of the "Bologna criteria" and the introduction of long acting gonadotropin in clinical practice have given rise to new promising stimulation protocols for this group of patients.
尽管在过去二十年里，文献中发表了大量关于卵巢反应不良这一主题的论文，但迄今为止，仍无法确定任何有效的治疗方法来改善这组患者的卵巢反应及临床结局。据估计，不孕女性中卵巢反应不良者的发生率为9%至24%，但根据最近的综述，这一比例似乎略有上升。在不孕人群中难以量化这些患者的发生率，原因在于文献中难以给出明确的定义。博洛尼亚ESHRE卵巢反应不良工作组最近发表的一篇论文是首次真正尝试寻找一个通用定义。当前文献提出了一些可能导致卵巢储备减少的新风险因素，其中也包括遗传因素。这是朝着为这些患者找到适用解决方案迈出的第一步。迄今为止，大量文献都未能确定针对这些患者的理想方案。“博洛尼亚标准”的应用以及长效促性腺激素在临床实践中的引入，为这组患者带来了新的、有前景的刺激方案。
