Boudry Liese, Racca Annalisa, Tournaye Herman, Blockeel Christophe
Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, 1090, Brussels, Belgium.
Department of Obstetrics, Gynecology and Reproduction, Hospital Universitari Dexeus, Barcelona, Spain.
Ther Adv Reprod Health. 2021 Jun 27;15:26334941211024203. doi: 10.1177/26334941211024203. eCollection 2021 Jan-Dec.
Infertile patients with a diminished ovarian reserve, also referred to as poor ovarian responders, constitute a substantial and increasing population of patients undergoing fertilization. The management of patients with poor ovarian response is still a controversial issue. Almost a century has passed since the introduction of the first gonadotropin. A broad collection of urinary and recombinant gonadotropins, including biosimilars, is commercially available now. Despite great advances in assisted reproductive technology, there remains uncertainty about the optimal treatment regimen for ovarian stimulation in poor ovarian responders. Although oocyte donation is the most successful and ultimate remedy for poor ovarian responders, most patients persist on using their own oocytes in several attempts, to achieve the desired pregnancy. The aim of this review is twofold: first, to provide an overview of the commercially available gonadotropins and summarize the available evidence supporting the use of one or another for ovarian stimulation in poor ovarian responders, and second, to address the controversies on the dosage of gonadotropins for this specific fertilization population.
卵巢储备功能减退的不孕患者，也被称为卵巢低反应者，在接受受精治疗的患者中占比相当大且呈上升趋势。卵巢低反应患者的管理仍是一个有争议的问题。自第一种促性腺激素问世以来，几乎已过去一个世纪。现在市面上有大量的尿源性和重组促性腺激素，包括生物类似药。尽管辅助生殖技术取得了巨大进展，但对于卵巢低反应者卵巢刺激的最佳治疗方案仍存在不确定性。虽然卵母细胞捐赠是卵巢低反应者最成功且最终的治疗方法，但大多数患者仍会多次尝试使用自己的卵母细胞来实现理想的妊娠。本综述的目的有两个：第一，概述市面上可获得的促性腺激素，并总结支持在卵巢低反应者中使用某一种或另一种促性腺激素进行卵巢刺激的现有证据；第二，探讨针对这一特定受精人群促性腺激素剂量的争议。
