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卵巢刺激方式在反应不良者中的应用。

Ovarian stimulation modalities in poor responders.

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Kırıkkale University, Kırıkkale, Turkey

出版信息

Turk J Med Sci. 2019 Aug 8;49(4):959-962. doi: 10.3906/sag-1905-179.

DOI:10.3906/sag-1905-179
PMID:31385487
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7018357/
Abstract

In a group of IVF/ICSI cycles, despite the appropriate ovarian stimulation, the number of oocytes collected is below the expected value. This condition is defined as poor ovarian response (POR) to stimulation. POR brings the risk of cycle cancellation with an estimated rate of 20%. Infertility experts are trying to improve cycle outcomes of POR cases with multiple modifications. This review article will present the latest modifications on the management of POR. The studies performed for improving cycle outcome in POR cases were evaluated and their notable results were presented. The first intervention among infertility specialists is to make a standard definition for POR. The BOLOGNA criteria and the subsequent POSEIDON group definitions are the latest updates in POR management. GnRH antagonists, estradiol priming, double stimulation, letrozole administration, DHEA, and herbal therapy supplementations are the recent modifications done to improve oocyte retrieval and subsequent embryo transfer for POR cases. This review article presents the encouraging methods applied for POR cases to improve cycle outcome.

摘要

在一组体外受精/卵胞浆内单精子注射(IVF/ICSI)周期中,尽管进行了适当的卵巢刺激,但采集的卵母细胞数量低于预期。这种情况被定义为卵巢刺激反应不良(POR)。POR 带来了取消周期的风险,估计发生率为 20%。不孕专家正在尝试通过多种改良来改善 POR 病例的周期结局。本文将介绍 POR 管理的最新改良措施。评估了为改善 POR 病例的周期结局而进行的研究,并介绍了其显著结果。不孕专家的第一步干预措施是为 POR 制定标准定义。BOLOGNA 标准和随后的 POSEIDON 组定义是 POR 管理的最新更新。GnRH 拮抗剂、雌二醇预处理、双重刺激、来曲唑给药、DHEA 和草药疗法补充剂是为改善 POR 病例的卵母细胞采集和随后的胚胎移植而进行的最新改良措施。本文介绍了为改善 POR 病例的周期结局而应用的令人鼓舞的方法。

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J Ethnopharmacol. 2019 Jul 15;239:111885. doi: 10.1016/j.jep.2019.111885. Epub 2019 Apr 19.
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Double mild stimulation and egg collection in the same cycle for management of poor ovarian responders.同期双次温和刺激与取卵用于卵巢低反应者的处理
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Effect of mid-follicular phase recombinant LH versus urinary HCG supplementation in poor ovarian responders undergoing IVF - a prospective double-blinded randomized study.卵泡中期重组促黄体生成素与尿人绒毛膜促性腺激素补充治疗对卵巢反应不良患者体外受精的影响——一项前瞻性双盲随机研究
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A randomized, single-blind, prospective trial comparing three different gonadotropin doses with or without addition of letrozole during ovulation stimulation in patients with poor ovarian response.一项随机、单盲、前瞻性试验,比较三种不同促性腺激素剂量在有或没有添加来曲唑的情况下对卵巢反应不良患者进行排卵刺激的效果。
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A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept.卵巢刺激低反应者的一种新的更详细分层:从卵巢反应不良到低预后概念。
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Hum Reprod. 2016 Feb;31(2):370-6. doi: 10.1093/humrep/dev316. Epub 2016 Jan 2.
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Dehydroepiandrosterone as an adjunct to gonadotropins in infertile Indian women with premature ovarian aging: A pilot study.
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J Clin Endocrinol Metab. 2015 Nov;100(11):4372-81. doi: 10.1210/jc.2015-1946. Epub 2015 Oct 1.