Bourdon Mathilde, Santulli Pietro, Maignien Chloé, Pocate-Cheriet Khaled, Marcellin Louis, Chen Yulian, Chapron Charles
Department of GynaecologyObstetrics II and Reproductive Medicine Paris, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Paris, France.
Institut Cochin, INSERM U1016, Laboratoire d'immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Reprod Sci. 2020 Jan;27(1):204-210. doi: 10.1007/s43032-019-00012-9. Epub 2020 Jan 1.
The double-ovarian stimulation strategy has been proposed to optimize the number of oocytes retrieved within the shortest possible timeframe. The objective of this study is to explore the effectiveness of luteal phase (LP) ovarian stimulation as compared to the previous follicular phase (FP) stimulation in a double stimulation strategy. We conducted an observational cohort study of women scheduled for a double stimulation protocol between March 2014 and June 2017, who had completed the FP controlled ovarian stimulation (COS 1) and started the LP stimulation (COS 2) in the same cycle. Women received equivalent daily doses of gonadotropins in combination with GnRH-antagonist protocol for both the COS 1 and the COS 2 performed during the same cycle. Ovulation was triggered using GnRH-agonist in the two stimulations. The primary outcome was the number of oocytes retrieved. A total of 77 patients were included in the analysis. The number of oocytes retrieved after COS 1 was significantly higher than after the COS 2 (5.25 ± 3.38 for COS 1 versus 3.83 ± 3.14 for COS 2; p = 0.001). The duration of the stimulation was significantly shorter, the total dose of injected gonadotropins was significantly lower, and the estradiol level on the trigger day was significantly higher with COS 1 as compared to COS 2. Stimulation during the LP in a double-successive stimulation strategy results in a lower ovarian response as compared to the FP equivalent daily dose stimulation.
双卵巢刺激策略已被提出，目的是在尽可能短的时间内优化获取的卵母细胞数量。本研究的目的是探讨在双刺激策略中，黄体期（LP）卵巢刺激与先前卵泡期（FP）刺激相比的有效性。我们对2014年3月至2017年6月计划进行双刺激方案的女性进行了一项观察性队列研究，这些女性在同一周期内完成了FP控制性卵巢刺激（COS 1）并开始了LP刺激（COS 2）。在同一周期内进行的COS 1和COS 2中，女性接受等量的每日促性腺激素剂量，并联合GnRH拮抗剂方案。两次刺激均使用GnRH激动剂触发排卵。主要结局是获取的卵母细胞数量。共有77例患者纳入分析。COS 1后获取的卵母细胞数量显著高于COS 2后（COS 1为5.25±3.38，COS 2为3.83±3.14；p = 0.001）。与COS 2相比，COS 1的刺激持续时间显著更短，注射促性腺激素的总剂量显著更低，触发日的雌二醇水平显著更高。与FP等量每日剂量刺激相比，连续双刺激策略中LP期间的刺激导致较低的卵巢反应。
