Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy.
Centro Scienze Natalità, Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy.
Trends Endocrinol Metab. 2020 Apr;31(4):296-307. doi: 10.1016/j.tem.2020.01.009. Epub 2020 Feb 5.
Controlled ovarian hyperstimulation (COH) determines an anticipation of endometrial maturation and a premature occurrence of the implantation window, as shown by histological, histochemical, and molecular studies and indirectly by clinical trials. There is growing agreement that in patients hyper-responding to COH and in those undergoing transfer at the blastocyst stage, deferring the transfer in a subsequent frozen cycle could increase pregnancy outcomes. For blastocysts, implantation after a fresh transfer may be limited as the implantation window is already closed while, in hyper-responders to COH, the anticipation magnitude could be more marked thus hampering implantation also for cleavage-stage embryos. Research should focus in depth on pregnancy outcomes and on the most suitable modality to prepare the endometrium for frozen transfers.
控制性卵巢刺激（COH）可通过组织学、组织化学和分子研究以及间接的临床试验来预测子宫内膜的成熟和种植窗的提前发生。越来越多的人认为，在对 COH 反应过度的患者和在囊胚阶段进行移植的患者中，在下一个冷冻周期中推迟移植可以提高妊娠结局。对于囊胚，在新鲜周期中进行移植可能会受到限制，因为种植窗已经关闭，而在 COH 反应过度的患者中，这种预期的幅度可能更为显著，从而也阻碍了卵裂期胚胎的着床。研究应深入关注妊娠结局和最适合的方法，以准备冷冻移植的子宫内膜。
