Kuang Yanping, Chen Qiuju, Hong Qingqing, Lyu Qifeng, Ai Ai, Fu Yonglun, Shoham Zeev
Department of Assisted Reproduction, Shanghai Ninth People's Hospital affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Assisted Reproduction, Shanghai Ninth People's Hospital affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Reprod Biomed Online. 2014 Dec;29(6):684-91. doi: 10.1016/j.rbmo.2014.08.009. Epub 2014 Sep 6.
Previous studies have shown that existing antral follicles in the luteal phase enable ovarian stimulation. In a pilot study, the efficacy of double stimulations during the follicular and luteal phases in women with poor ovarian response was explored (defined according to the Bologna criteria). Thirty-eight women began with mild ovarian stimulation. After the first oocyte retrieval, human menopausal gonadotrophin and letrozole were administrated to stimulate follicle development, and oocyte retrieval was carried out a second time when dominant follicles had matured. The primary outcome measured was the number of oocytes retrieved: stage one 1.7 ± 1.0; stage two 3.5 ± 3.2. From the double stimulation, 167 oocytes were collected and 26 out of 38 (68.4%) succeeded in producing one to six viable embryos cryopreserved for later transfer. Twenty-one women underwent 23 cryopreserved embryo transfers, resulting in 13 clinical pregnancies. The study shows that double ovarian stimulations in the same menstrual cycle provide more opportunities for retrieving oocytes in poor responders. The stimulation can start in the luteal phase resulting in retrieval of more oocytes in a short period of time. This offers new hope for women with poor ovarian response and newly diagnosed cancer patients needing fertility preservation.
以往研究表明，黄体期现有的窦卵泡可用于卵巢刺激。在一项前瞻性研究中，探讨了在卵巢反应不良的女性（根据博洛尼亚标准定义）中，卵泡期和黄体期双重刺激的效果。38名女性开始进行温和的卵巢刺激。在第一次取卵后，给予人绝经期促性腺激素和来曲唑以刺激卵泡发育，当优势卵泡成熟时进行第二次取卵。测量的主要结果是取到的卵母细胞数量：第一阶段为1.7±1.0；第二阶段为3.5±3.2。通过双重刺激，共收集到167个卵母细胞，38名女性中有26名（68.4%）成功产生了1至6个可存活胚胎并冷冻保存以备后续移植。21名女性接受了23次冷冻胚胎移植，产生了13例临床妊娠。该研究表明，在同一月经周期内进行双重卵巢刺激可为卵巢反应不良者提供更多取卵机会。刺激可在黄体期开始，从而在短时间内取到更多卵母细胞。这为卵巢反应不良的女性以及需要保留生育能力的新诊断癌症患者带来了新希望。
