Howles Colin M, Ezcurra Diego, Homburg Roy
a Merck Serono S.A. - Geneva , Geneva, Switzerland.
c Merck Serono S.A. - Geneva , Geneva, Switzerland.
Expert Rev Endocrinol Metab. 2012 May;7(3):319-330. doi: 10.1586/eem.12.18.
Controlled ovarian stimulation (COS) with gonadotropins to produce multiple follicular development and high-quality oocytes is the cornerstone of assisted reproductive technology. Today, recombinant human follicle-stimulating hormone (r-hFSH) is widely used for COS. A long-acting r-hFSH and a combination of r-hFSH and recombinant human luteinizing hormone have recently become available. Formulations of purified urinary FSH with or without luteinizing hormone activity (provided by human chorionic gonadotropin) are also available. COS protocols can now be individualized to optimize efficacy and safety - defined as singleton pregnancies with a low incidence of ovarian hyperstimulation syndrome. This is facilitated by an estimation of ovarian response using the antral follicle count and/or serum anti-Müllerian hormone levels; anti-Müllerian hormone is viewed as the most reliable single marker. However, an efficient management strategy for poor responders to COS is still required. Developments in biomarkers and other techniques for accurate identification of viable oocytes and embryos and optimal uterine receptivity are expected.
使用促性腺激素进行控制性卵巢刺激（COS）以产生多个卵泡发育和高质量卵母细胞是辅助生殖技术的基石。如今，重组人促卵泡激素（r-hFSH）被广泛用于COS。一种长效r-hFSH以及r-hFSH与重组人促黄体生成素的组合最近已上市。具有或不具有促黄体生成素活性（由人绒毛膜促性腺激素提供）的纯化尿促卵泡素制剂也有。现在，COS方案可以个体化以优化疗效和安全性——定义为单胎妊娠且卵巢过度刺激综合征发生率低。通过使用窦卵泡计数和/或血清抗苗勒管激素水平来估计卵巢反应有助于实现这一点；抗苗勒管激素被视为最可靠的单一标志物。然而，对于COS反应不良者仍需要一种有效的管理策略。预计在生物标志物和其他技术方面会有进展，以准确识别有活力的卵母细胞和胚胎以及最佳子宫容受性。
