Zeyneloglu Hulusi Bulent, Tohma Yusuf Aytac, Gunakan Emre, Onalan Gogsen, Eryılmaz Tahir
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey.
Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey.
Gynecol Endocrinol. 2021 Nov;37(11):1000-1002. doi: 10.1080/09513590.2021.1922885. Epub 2021 May 4.
In this study, we aimed to compare the efficacy of luteal phase stimulation (LPS) and follicular phase stimulation (FPS) in two separate menstrual cycles (2-5 months intervals) of the same patient, utilizing LPS with dydrogesteron only.
This retrospective case control study was conducted with patients with diminished ovarian reserve (DOR) (Group 1) and infertile patients with Anti-Müllerian hormone >1.2 ng/mL (Group 2) undergoing two ovarian stimulations (FPS and LPS with dydrogesteron only) and two oocyte retrievals in two separate menstrual cycles (2-5 months intervals) in the Division of Reproductive Endocrinology and Infertility of Baskent University, Ankara, between April 2019 and December 2019.
In group 1, the number of frozen embryos was significantly higher in LPS when compared to FPS; 1.71 vs. 0.54, ( < .001), respectively. In group 2, the number of frozen embryos was higher in LPS when compared to FPS (0.8 vs. 0.4) however the difference did not reach a statistical significance (: 0.157).
LPS may be beneficial especially in the patients with diminished ovarian reserve with follicular asynchronization in the menstrual onset. In addition, it should be kept in mind that dydrogesterone only may be used instead of gonadotropin-releasing hormone antagonist to prevent possible luteinizing hormone rise in LPS.
在本研究中，我们旨在比较同一患者在两个独立月经周期（间隔2 - 5个月）中黄体期刺激（LPS）和卵泡期刺激（FPS）的效果，仅使用地屈孕酮进行LPS。
本回顾性病例对照研究纳入了卵巢储备功能减退（DOR）患者（第1组）和抗苗勒管激素>1.2 ng/mL的不孕患者（第2组），于2019年4月至2019年12月在安卡拉巴斯肯大学生殖内分泌与不孕症科进行了两次卵巢刺激（FPS和仅使用地屈孕酮的LPS）以及两次卵母细胞采集，两个刺激过程在两个独立月经周期（间隔2 - 5个月）中进行。
在第1组中，与FPS相比，LPS时冷冻胚胎数量显著更高，分别为1.71 vs. 0.54，（P <.001）。在第2组中，LPS时冷冻胚胎数量高于FPS（0.8 vs. 0.4），但差异未达到统计学显著性（P：0.157）。
LPS可能尤其有益于月经初潮时卵泡不同步的卵巢储备功能减退患者。此外，应记住在LPS中仅使用地屈孕酮可替代促性腺激素释放激素拮抗剂以防止可能出现的黄体生成素升高。
