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在同一卵巢周期内进行双重刺激(DuoStim)是一种在短时间内提高卵母细胞产量和优质胚胎数量的有趣策略。

Double stimulation in the same ovarian cycle (DuoStim) is an intriguing strategy to improve oocyte yield and the number of competent embryos in a short timeframe.

作者信息

Vaiarelli Alberto, Cimadomo Danilo, Argento Cindy, Ubaldi Nicolò, Trabucco Elisabetta, Drakopoulos Panagiotis, Venturella Roberta, Conforti Alessandro, Alviggi Carlo, Rienzi Laura, Ubaldi Filippo M

机构信息

G.EN.E.R.A. Center for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy -

G.EN.E.R.A. Center for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy.

出版信息

Minerva Ginecol. 2019 Oct;71(5):372-376. doi: 10.23736/S0026-4784.19.04390-9. Epub 2019 Mar 4.

Abstract

Proper ovarian stimulation regimens are crucial for any patient undergoing in-vitro fertilization (IVF). However, maximizing the oocyte yield in advanced maternal age patients with poor or suboptimal response is still a challenge. In fact, no standard treatment has been outlined yet to manage these women. Across the last years, an improved efficiency of the IVF units via blastocyst culture, vitrification and reliable embryo selection approaches paved the way to the investigation of novel unconventional stimulation protocols, like double stimulation in a single ovarian cycle (DuoStim). DuoStim, by conjugating follicular phase stimulation (FPS) and luteal phase stimulation (LPS) in the same ovarian cycle, allows to maximize the number of oocytes obtained in a short timeframe, a precious outcome when we aim at shortening time to pregnancy. In this regard, LPS seems to contribute to conventional stimulation with more oocytes with a comparable competence as FPS, retrieved per ovarian cycle. Although any stimulation protocol which exploits anovulatory waves of follicular growth needs a thorough investigation, no evidence has been produced to question the safety of DuoStim, which to date represents the most intriguing strategy to treat poor prognosis in IVF.

摘要

合适的卵巢刺激方案对于任何接受体外受精(IVF)的患者来说都至关重要。然而,对于高龄且反应不佳或欠佳的患者而言,最大化卵母细胞产量仍是一项挑战。事实上,目前尚未制定出针对这些女性的标准治疗方案。在过去几年中,通过囊胚培养、玻璃化冷冻和可靠的胚胎选择方法提高了IVF单位的效率,为研究新型非常规刺激方案(如在单个卵巢周期中进行双重刺激,即双刺激)铺平了道路。双刺激通过在同一卵巢周期中结合卵泡期刺激(FPS)和黄体期刺激(LPS),能够在短时间内最大化获得的卵母细胞数量,当我们旨在缩短怀孕时间时,这是一个宝贵的成果。在这方面,黄体期刺激似乎有助于常规刺激,每个卵巢周期获得的卵母细胞数量与卵泡期刺激相当,且能力相当。尽管任何利用卵泡生长无排卵波的刺激方案都需要进行深入研究,但尚无证据质疑双刺激的安全性,迄今为止,双刺激是治疗IVF预后不良最具吸引力的策略。

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