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本文引用的文献

1
International Committee for Monitoring Assisted Reproductive Technologies world report: Assisted Reproductive Technology 2008, 2009 and 2010.国际辅助生殖技术监测委员会世界报告:2008年、2009年及2010年辅助生殖技术情况
Hum Reprod. 2016 Jul;31(7):1588-609. doi: 10.1093/humrep/dew082. Epub 2016 May 20.
2
To pill or not to pill in GnRH antagonist cycles: that is the question!在促性腺激素释放激素拮抗剂周期中是否用药:这是个问题!
Reprod Biomed Online. 2015 Jan;30(1):39-42. doi: 10.1016/j.rbmo.2014.09.010. Epub 2014 Oct 5.
3
Comparison of early versus late initiation of GnRH antagonist co-treatment for controlled ovarian stimulation in IVF: a randomized controlled trial.比较 GnRH 拮抗剂协同治疗在 IVF 中控制性卵巢刺激的早期与晚期启动:一项随机对照试验。
Hum Reprod. 2013 Dec;28(12):3227-35. doi: 10.1093/humrep/det374. Epub 2013 Oct 15.
4
Progesterone elevation and probability of pregnancy after IVF: a systematic review and meta-analysis of over 60 000 cycles.孕激素升高与 IVF 后妊娠概率:超过 60000 个周期的系统评价和荟萃分析。
Hum Reprod Update. 2013 Sep-Oct;19(5):433-57. doi: 10.1093/humupd/dmt014. Epub 2013 Jul 4.
5
Timing of human chorionic gonadotrophin (hCG) hormone administration in IVF protocols using GnRH antagonists: a randomized controlled trial.在使用促性腺激素释放激素(GnRH)拮抗剂的体外受精(IVF)方案中,人绒毛膜促性腺激素(hCG)给药时机的随机对照试验。
Hum Fertil (Camb). 2012 Sep;15(3):134-9. doi: 10.3109/14647273.2012.712739.
6
Can oestradiol pretreatment be used to reliably avoid weekend oocyte retrievals?雌二醇预处理能否可靠地避免周末取卵?
Reprod Biomed Online. 2012 May;24(5):487-9. doi: 10.1016/j.rbmo.2012.01.026. Epub 2012 Feb 3.
7
Oestradiol valerate pretreatment in GnRH-antagonist cycles: a randomized controlled trial.戊酸雌二醇预处理 GnRH 拮抗剂周期:一项随机对照试验。
Reprod Biomed Online. 2012 Mar;24(3):272-80. doi: 10.1016/j.rbmo.2011.11.012. Epub 2011 Nov 30.
8
Is earlier administration of human chorionic gonadotropin (hCG) associated with the probability of pregnancy in cycles stimulated with recombinant follicle-stimulating hormone and gonadotropin-releasing hormone (GnRH) antagonists? A prospective randomized trial.在使用重组卵泡刺激素和促性腺激素释放激素(GnRH)拮抗剂刺激的周期中,较早给予人绒毛膜促性腺激素(hCG)是否与妊娠的可能性相关?一项前瞻性随机试验。
Fertil Steril. 2011 Nov;96(5):1112-5. doi: 10.1016/j.fertnstert.2011.08.029. Epub 2011 Sep 15.
9
Timing oocyte collection in GnRH agonists down-regulated IVF and ICSI cycles: a randomized clinical trial.促性腺激素释放激素激动剂下调 IVF 和 ICSI 周期中取卵时机的随机临床试验。
Hum Reprod. 2011 May;26(5):1091-6. doi: 10.1093/humrep/der048. Epub 2011 Feb 28.
10
Oral contraceptive pretreatment significantly reduces ongoing pregnancy likelihood in gonadotropin-releasing hormone antagonist cycles: an updated meta-analysis.促性腺激素释放激素拮抗剂周期中,口服避孕药预处理显著降低持续性妊娠的可能性:一项更新的荟萃分析。
Fertil Steril. 2010 Nov;94(6):2382-4. doi: 10.1016/j.fertnstert.2010.04.025. Epub 2010 May 26.

无周末安排的体外受精/卵胞浆内单精子注射程序及单胚胎移植并不会降低普通不孕人群的活产率。

Weekend-free scheduled IVF/ICSI procedures and single embryo transfer do not reduce live-birth rates in a general infertile population.

作者信息

Feichtinger Michael, Karlström Per O, Olofsson Jan I, Rodriguez-Wallberg Kenny A

机构信息

Reproductive Medicine, Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden.

Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria.

出版信息

Acta Obstet Gynecol Scand. 2017 Dec;96(12):1423-1429. doi: 10.1111/aogs.13235. Epub 2017 Oct 31.

DOI:10.1111/aogs.13235
PMID:28940191
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6055597/
Abstract

INTRODUCTION

Scheduling of ovum pickup only on weekdays may result in cases of apparently suboptimal timing for human chorionic gonadotropin and ovum pickup. This study aimed to assess whether live-birth rates were reduced in women with a potentially suboptimal day for human chorionic gonadotropin and ovum pickup to avoid weekend work, according to ultrasonographic data on the day of human chorionic gonadotropin planning.

MATERIAL AND METHODS

An evaluation of the optimal human chorionic gonadotropin priming date was performed in treatment protocols of 1000 consecutive patients undergoing their first in vitro fertilization/intracytoplasmatic sperm injection with single-embryo transfer. An ideal ovum pickup day was characterized by human chorionic gonadotropin-scheduling when three or more follicles reached 17 mm (day 0) or with one day of delay (day +1) (n = 760). A non-ideal ovum pickup was either early (day -1, -2, -3) (n = 24) or delayed (day +2, +3, +4) (n = 216). Live-birth rates in the ideal and non-ideal ovum pickup groups was set as primary outcome measure.

RESULTS

Early-ovum pickups were excluded as they were infrequent. No differences between ideal and delayed ovum pickup groups were found regarding number of oocytes retrieved (9.87 vs. 9.78, p = 0.990), pregnancy rates (28.3% vs. 29.6%, p = 0.701) or live-birth rates (26.2% vs. 25.9%, p = 0.939). However, sub analyses indicated that treatment with gonadotropin releasing hormone antagonists resulted in significantly lower clinical pregnancy rates in delayed ovum pickups (odds ratio 0.46, p = 0.014), compared with agonist treatments.

CONCLUSIONS

Weekend work may not be needed for in vitro fertilization/intracytoplasmatic sperm injection single-embryo transfer treatments. However, in gonadotropin releasing hormone antagonist cycles, delaying ovum pickup more than one day may result in unfavorable outcomes.

摘要

引言

仅在工作日安排取卵可能会导致人绒毛膜促性腺激素(hCG)注射和取卵时机明显欠佳的情况。本研究旨在根据hCG注射当天的超声数据,评估因避免周末工作而导致hCG注射和取卵时机潜在欠佳的女性的活产率是否降低。

材料与方法

对1000例连续接受首次体外受精/卵胞浆内单精子注射并进行单胚胎移植的患者的治疗方案进行最佳hCG启动日期评估。理想的取卵日的特征是,当三个或更多卵泡达到17毫米时(第0天)或延迟一天(第+1天)进行hCG注射(n = 760)。不理想的取卵要么过早(第-1、-2、-3天)(n = ),要么延迟(第+2、+3、+4天)(n = 216)。理想和不理想取卵组的活产率被设定为主要结局指标。

结果

由于过早取卵情况罕见,故将其排除。在获取的卵母细胞数量(9.87对9.78,p = 0.990)、妊娠率(28.3%对29.6%,p = 0.701)或活产率(26.2%对25.9%,p = 0.939)方面,理想和延迟取卵组之间未发现差异。然而,亚组分析表明,与激动剂治疗相比,使用促性腺激素释放激素拮抗剂治疗导致延迟取卵时临床妊娠率显著降低(优势比0.46,p = 0.014)。

结论

体外受精/卵胞浆内单精子注射单胚胎移植治疗可能无需在周末工作。然而,在促性腺激素释放激素拮抗剂周期中,取卵延迟超过一天可能会导致不良结局。 (注:原文中“过早取卵情况罕见,故将其排除”处“n = ”原文有误,未给出具体数字)