围绕轻度刺激体外受精（IVF）的种种误解。
The myths surrounding mild stimulation in vitro fertilization (IVF).
作者信息
Orvieto Raoul, Vanni Valeria Stella, Gleicher Norbert
机构信息
Infertility and IVF unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
出版信息
Reprod Biol Endocrinol. 2017 Jun 24;15(1):48. doi: 10.1186/s12958-017-0266-1.
Abstract
So-called mild controlled ovarian hyperstimulation (mCOH) has in recent years increased in popularity, claiming to be safer and more patient-friendly, while also improving in vitro fertilization (IVF) outcomes. We here challenge the International Society for Mild Approaches in Assisted Reproduction (ISMAAR) definition of mild stimulation, and especially address four fundamental issues, where our review found conventional COH (cCOH) advantageous over mCOH. They are: prevalence of severe ovarian hyperstimulation syndrome (OHSS), oocyte/embryo quality, pregnancy/live birth rates, and cost. We conclude that an objective review of the literature does not support the routine utilization of mCOH in assisted reproduction.
摘要
近年来，所谓的温和控制性卵巢刺激（mCOH）越来越受欢迎，声称更安全、对患者更友好，同时还能改善体外受精（IVF）的结局。在此，我们对辅助生殖温和方法国际协会（ISMAAR）对温和刺激的定义提出质疑，尤其关注四个基本问题，我们的综述发现传统控制性卵巢刺激（cCOH）在这些方面比mCOH更具优势。它们是：重度卵巢过度刺激综合征（OHSS）的发生率、卵母细胞/胚胎质量、妊娠/活产率以及成本。我们的结论是，对文献的客观综述并不支持在辅助生殖中常规使用mCOH。
相似文献
1
The myths surrounding mild stimulation in vitro fertilization (IVF).围绕轻度刺激体外受精（IVF）的种种误解。
Reprod Biol Endocrinol. 2017 Jun 24;15(1):48. doi: 10.1186/s12958-017-0266-1.
2
[Study on clinical effect on infertility women with polycystic ovary syndrome treated by in vitro maturation and in vitro fertilization-embryo transfer].[体外成熟与体外受精-胚胎移植治疗多囊卵巢综合征不孕女性的临床效果研究]
Zhonghua Fu Chan Ke Za Zhi. 2012 Apr;47(4):250-4.
3
4
Efficiency of mild ovarian stimulation with clomiphene on poor ovarian responders during IVF\ICSI procedures: a meta-analysis.克罗米芬轻度卵巢刺激对体外受精/卵胞浆内单精子注射过程中卵巢反应不良者的有效性：一项荟萃分析。
Eur J Obstet Gynecol Reprod Biol. 2016 Sep;204:36-43. doi: 10.1016/j.ejogrb.2016.07.498. Epub 2016 Aug 3.
5
Assisted reproductive techniques.辅助生殖技术
Methods Mol Biol. 2014;1154:171-231. doi: 10.1007/978-1-4939-0659-8_8.
6
A high number of oocytes obtained after ovarian hyperstimulation for in vitro fertilization or intracytoplasmic sperm injection is not associated with decreased pregnancy outcome.体外受精或卵胞浆内单精子注射卵巢过度刺激后获得大量卵母细胞与妊娠结局降低无关。
Fertil Steril. 2006 Apr;85(4):918-24. doi: 10.1016/j.fertnstert.2005.09.035.
7
Luteal-phase ovarian stimulation is feasible for producing competent oocytes in women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment, with optimal pregnancy outcomes in frozen-thawed embryo transfer cycles.黄体期卵巢刺激对于接受体外受精/胞浆内单精子注射治疗的女性来说是可行的，可产生有活力的卵子，并且在冷冻胚胎移植周期中获得最佳的妊娠结局。
Fertil Steril. 2014 Jan;101(1):105-11. doi: 10.1016/j.fertnstert.2013.09.007. Epub 2013 Oct 23.
8
[Effect of domestic highly purified urinary follicle stimulating hormone on outcomes of in vitro fertilization-embryo transfer in controlled ovarian stimulation].国产高纯度尿促卵泡素对控制性卵巢刺激中体外受精-胚胎移植结局的影响
Zhonghua Fu Chan Ke Za Zhi. 2013 Nov;48(11):838-42.
9
Modified natural cycle versus controlled ovarian hyperstimulation IVF: a cost-effectiveness evaluation of three simulated treatment scenarios.改良自然周期与控制性卵巢过度刺激 IVF：三种模拟治疗方案的成本效益评估。
Hum Reprod. 2013 Dec;28(12):3236-46. doi: 10.1093/humrep/det386. Epub 2013 Oct 27.
10
Is IVF-served two different ways-more cost-effective than IUI with controlled ovarian hyperstimulation?试管婴儿服务有两种不同方式——比控制性卵巢过度刺激下的宫腔内人工授精更具成本效益吗？
Hum Reprod. 2015 Oct;30(10):2331-9. doi: 10.1093/humrep/dev193. Epub 2015 Aug 12.
引用本文的文献
1
Time associations between U.S. birth rates and add-Ons to IVF practice between 2005-2016.2005-2016 年美国出生率与体外受精实践附加项目之间的时间关联。
Reprod Biol Endocrinol. 2021 Jul 13;19(1):110. doi: 10.1186/s12958-021-00793-2.
2
New Twists in Ovarian Stimulation and Their Practical Implications.卵巢刺激的新进展及其实际意义。
Front Med (Lausanne). 2019 Sep 4;6:197. doi: 10.3389/fmed.2019.00197. eCollection 2019.
3
Observational retrospective study of US national utilisation patterns and live birth rates for various ovarian stimulation protocols for in vitro fertilisation.美国体外受精各种卵巢刺激方案的全国使用模式和活产率的观察性回顾研究。
BMJ Open. 2018 Nov 8;8(11):e023124. doi: 10.1136/bmjopen-2018-023124.
4
Mild ovarian stimulation with letrozole plus fixed dose human menopausal gonadotropin prior to IVF/ICSI for infertile non-obese women with polycystic ovarian syndrome being pre-treated with metformin: a pilot study.在接受二甲双胍预处理的肥胖型多囊卵巢综合征不孕不育非肥胖妇女中，采用来曲唑联合固定剂量人绝经期促性腺激素进行轻度卵巢刺激，以进行体外受精/卵胞浆内单精子注射：一项初步研究。
Reprod Biol Endocrinol. 2018 Sep 14;16(1):89. doi: 10.1186/s12958-018-0405-3.
本文引用的文献
1
Is the hypothesis of preimplantation genetic screening (PGS) still supportable? A review.胚胎植入前遗传学筛查（PGS）假说是否仍站得住脚？一篇综述。
J Ovarian Res. 2017 Mar 27;10(1):21. doi: 10.1186/s13048-017-0318-3.
2
The cumulative dose of gonadotropins used for controlled ovarian stimulation does not influence the odds of embryonic aneuploidy in patients with normal ovarian response.用于控制性卵巢刺激的促性腺激素累积剂量不影响卵巢反应正常患者胚胎非整倍体的几率。
J Assist Reprod Genet. 2017 Jun;34(6):749-758. doi: 10.1007/s10815-017-0909-3. Epub 2017 Mar 20.
3
Accuracy of preimplantation genetic screening (PGS) is compromised by degree of mosaicism of human embryos.植入前基因筛查（PGS）的准确性受到人类胚胎嵌合程度的影响。
Reprod Biol Endocrinol. 2016 Sep 5;14(1):54. doi: 10.1186/s12958-016-0193-6.
4
Live birth and perinatal outcomes following stimulated and unstimulated IVF: analysis of over two decades of a nationwide data.刺激与未刺激体外受精后的活产及围产期结局：基于全国范围二十多年数据的分析
Hum Reprod. 2016 Oct;31(10):2261-7. doi: 10.1093/humrep/dew184. Epub 2016 Sep 2.
5
Conventional ovarian stimulation and single embryo transfer for IVF/ICSI. How many oocytes do we need to maximize cumulative live birth rates after utilization of all fresh and frozen embryos?体外受精/卵胞浆内单精子注射的传统卵巢刺激和单胚胎移植。在利用所有新鲜和冷冻胚胎后，我们需要多少个卵母细胞才能使累积活产率最大化？
Hum Reprod. 2016 Feb;31(2):370-6. doi: 10.1093/humrep/dev316. Epub 2016 Jan 2.
6
Healthy Babies after Intrauterine Transfer of Mosaic Aneuploid Blastocysts.嵌合非整倍体囊胚宫内移植后获得健康婴儿
N Engl J Med. 2015 Nov 19;373(21):2089-90. doi: 10.1056/NEJMc1500421.
7
Ovarian hyperstimulation syndrome- an optimal solution for an unresolved enigma.卵巢过度刺激综合征——未解之谜的最佳解决方案。
J Ovarian Res. 2013 Nov 5;6(1):77. doi: 10.1186/1757-2215-6-77.
8
Modified natural cycle versus controlled ovarian hyperstimulation IVF: a cost-effectiveness evaluation of three simulated treatment scenarios.改良自然周期与控制性卵巢过度刺激 IVF：三种模拟治疗方案的成本效益评估。
Hum Reprod. 2013 Dec;28(12):3236-46. doi: 10.1093/humrep/det386. Epub 2013 Oct 27.
9
Moderate ovarian stimulation does not increase the incidence of human embryo chromosomal abnormalities in in vitro fertilization cycles.中度卵巢刺激不会增加体外受精周期中人类胚胎染色体异常的发生率。
J Clin Endocrinol Metab. 2012 Oct;97(10):E1987-94. doi: 10.1210/jc.2012-1738. Epub 2012 Aug 3.
10
Lessons from elective in vitro fertilization (IVF) in, principally, non-infertile women.非不孕女性选择性体外受精（IVF）的经验教训。
Reprod Biol Endocrinol. 2012 Jun 20;10:48. doi: 10.1186/1477-7827-10-48.
Zotero 插件