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择期卵母细胞冷冻保存的女性中随机起始卵巢刺激。

Random-start ovarian stimulation in women desiring elective cryopreservation of oocytes.

机构信息

Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY, USA.

Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY, USA.

出版信息

Reprod Biomed Online. 2017 Oct;35(4):400-406. doi: 10.1016/j.rbmo.2017.06.002. Epub 2017 Jun 12.

Abstract

The current study investigates the utility of random-start ovarian stimulation in women desiring elective oocyte cryopreservation. Women in the study cohort underwent random-start ovarian stimulation, and were subdivided based on the phase of the menstrual cycle that ovarian stimulation began, i.e. early follicular, late follicular or luteal phase. Women undergoing conventional cycle day (CD) 2/3 ovarian stimulation start were controls. A total of 1302 women were included - 859 (66.0%) conventional CD 2/3, 342 (26.3%) early follicular, 42 (3.2%) late follicular and 59 (4.5%) luteal ovarian stimulation starts. There was no difference in the demographics or baseline ovarian stimulation characteristics. The duration of ovarian stimulation (11 versus 9 days; P < 0.001) and total dosage of gonadotrophins administered (4095.5 versus 3155 IU; P < 0.001) was higher in the random-start group. The number of total and MII oocytes in the control and random-start groups was similar. A non-significant trend towards increased cycle cancellation was noted in the late follicular start group (7.1%). Study findings indicate the number of total and MII oocytes derived from random-start protocols initiated during any phase of the menstrual cycle is similar to conventional CD 2/3 ovarian stimulation start protocols in women desiring elective oocyte cryopreservation.

摘要

本研究旨在探讨随机起始卵巢刺激在希望选择性卵母细胞冷冻保存的女性中的应用价值。研究队列中的女性接受随机起始卵巢刺激,并根据卵巢刺激开始的月经周期阶段进一步细分,即早卵泡期、晚卵泡期或黄体期。接受常规周期第 2/3 天(CD2/3)卵巢刺激开始的女性作为对照组。共纳入 1302 名女性 - 859 名(66.0%)常规 CD2/3,342 名(26.3%)早卵泡期,42 名(3.2%)晚卵泡期和 59 名(4.5%)黄体期卵巢刺激开始。两组的人口统计学特征或基线卵巢刺激特征无差异。随机起始组的卵巢刺激持续时间(11 天与 9 天;P < 0.001)和给予的促性腺激素总量(4095.5 与 3155IU;P < 0.001)较高。对照组和随机起始组的总卵子和 MII 卵子数量相似。晚卵泡期起始组的周期取消率呈增加趋势,但无统计学意义(7.1%)。研究结果表明,在希望选择性卵母细胞冷冻保存的女性中,任何月经周期阶段开始的随机起始方案获得的总卵子和 MII 卵子数量与常规 CD2/3 卵巢刺激起始方案相似。

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