IVI-RMA Lisboa, Avenida Infante Dom Henrique 333 H 1-9, 1800-282, Lisbon, Portugal.
Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels 1090, Belgium.
Best Pract Res Clin Endocrinol Metab. 2019 Feb;33(1):9-19. doi: 10.1016/j.beem.2018.10.006. Epub 2018 Nov 3.
Assisted reproductive technology (ART) has vastly improved over the last 40 years, from a frequently unsuccessful and complicated procedure requiring hospital admission and routine laparoscopy to a fairly simple outpatient technique with relatively high success rates. However, it is important to stress that ART is not without risk and medical complications may still occur. The incidence of most of these ART-related complications is associated with how women undergo ovarian stimulation. For this reason, physicians should be aware that a carefully thought-out ovarian stimulation protocol and cycle monitoring are of paramount importance to maximise the success of the treatment while avoiding potentially life-threating complications to occur in this frequently otherwise healthy patient population. This review discusses the rationale and evolution of ovarian stimulation strategies over the years and the current developments towards finding a balance between the retrieval of a sufficient number of oocytes and ART-related complication prevention.
辅助生殖技术(ART)在过去的 40 年中得到了极大的改善,从一项经常不成功且复杂的需要住院和常规腹腔镜检查的程序,发展为一项相当简单的门诊技术,成功率相对较高。然而,重要的是要强调,ART 并非没有风险,并且仍可能发生医疗并发症。这些与 ART 相关的并发症大多数与女性接受卵巢刺激的方式有关。因此,医生应该意识到,精心设计的卵巢刺激方案和周期监测对于最大限度地提高治疗成功率以及避免经常发生在这群健康人群中潜在危及生命的并发症至关重要。这篇综述讨论了多年来卵巢刺激策略的原理和演变,以及当前在寻找足够数量卵母细胞的获取和 ART 相关并发症预防之间取得平衡的进展。