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在接受 IVF/ICSI 周期的卵巢反应不良者中,最终卵母细胞成熟的双重触发。

Dual trigger of final oocyte maturation in poor ovarian responders undergoing IVF/ICSI cycles.

机构信息

Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China.

Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China.

出版信息

Reprod Biomed Online. 2017 Dec;35(6):701-707. doi: 10.1016/j.rbmo.2017.09.002. Epub 2017 Sep 21.

Abstract

Previous studies show that a dual trigger ovulation regimen significantly improves number and maturity of retrieved oocytes for normal ovarian responders or patients with history of low oocyte yield. The current retrospective cohort study investigated whether dual trigger of final oocyte maturation may benefit IVF outcomes for poor ovarian responders fulfilling the Bologna criteria. Undertaken between May 2014 and August 2016, the study involved 1350 patients undergoing 1389 IVF/intracytoplasmic sperm injection treatment cycles. Patients triggered with 5000 IU human chorionic gonadotrophin (HCG) alone (328 cycles) were compared with those undergoing dual triggering with 5000 IU HCG plus 0.1 mg gonadotrophin-releasing hormone agonist (GnRHa) (386 cycles) and patients triggered with 10,000 IU HCG (363 cycles) were compared with those undergoing dual triggering with 10,000 IU HCG plus 0.1 mg GnRHa (312 cycles). The dual trigger groups showed significantly higher number of oocytes collected and number of mature oocytes compared with their respective HCG trigger group (P < 0.001). Oocyte retrieval rate and percentage of mature oocytes retrieved were also both significantly higher in the dual trigger groups (P < 0.001). Fertilization rate, number of viable embryos, implantation rate, clinical pregnancy rate and miscarriage rate were not significantly different between groups.

摘要

先前的研究表明,双触发排卵方案可显著提高正常卵巢反应者或既往低卵母细胞产量患者的获卵数和成熟卵母细胞数。本回顾性队列研究旨在探讨对于符合博洛尼亚标准的卵巢反应不良者,是否可以通过双重触发卵母细胞最终成熟来改善体外受精结局。该研究于 2014 年 5 月至 2016 年 8 月进行,共纳入 1350 名接受 1389 个 IVF/卵胞浆内单精子注射治疗周期的患者。单独使用 5000IU 人绒毛膜促性腺激素(HCG)触发的患者(328 个周期)与接受双重触发(5000IU HCG 加 0.1mg 促性腺激素释放激素激动剂(GnRHa))的患者(386 个周期)进行比较,同时接受 10000IU HCG 触发的患者(363 个周期)与接受双重触发(10000IU HCG 加 0.1mg GnRHa)的患者(312 个周期)进行比较。与各自的 HCG 触发组相比,双重触发组采集的卵母细胞数和成熟卵母细胞数显著更高(P < 0.001)。双重触发组的卵母细胞回收率和成熟卵母细胞回收百分比也显著更高(P < 0.001)。受精率、可存活胚胎数、着床率、临床妊娠率和流产率在组间无显著差异。

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