通过间歇性阴道给予促性腺激素促进卵巢储备功能减退女性的卵泡生长

Ovarian Follicular Growth through Intermittent Vaginal Gonadotropin Administration in Diminished Ovarian Reserve Women.

作者信息

Hsu Chao-Chin, Hsu Isabel, Lee Li-Hsuan, Hsu Rosie, Hsueh Yuan-Shuo, Lin Chih-Ying, Chang Hui Hua

机构信息

Taiwan United Birth-Promoting Experts Fertility Clinic, Tainan 710, Taiwan.

Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei 104, Taiwan.

出版信息

Pharmaceutics. 2022 Apr 15;14(4):869. doi: 10.3390/pharmaceutics14040869.

Abstract

It is a challenge to obtain enough oocytes during in vitro fertilization (IVF) in women who have a poor ovarian response (POR) in achieving conception. We have adopted the characteristics of the first uterine pass effect, which we pioneered in employing the vaginal administration of gonadotropins in women receiving IVF treatments. In our previous study employing vaginal administration, faster absorption and slower elimination of gonadotropins were demonstrated, and, female subjects presented proper ovarian follicle growth and pregnancy rates. In this study, during 2016-2020, 300 to 675 IU of gonadotropins were administered vaginally every three days in 266 POR women for their controlled ovarian hyperstimulation (COH). The injections were performed with needles angled at 15-30° towards the middle-upper portions of the bilateral vaginal wall, with an injection depth of 1-2 mm. For the COH results, these women, on average, received 3.0 ± 0.9 vaginal injections and a total dose of 1318.4 ± 634.4 IU gonadotropins, resulting in 2.2 ± 1.9 mature oocytes and 1.0 ± 1.2 good embryos. Among these embryos, 0.9 ± 1.0 were transferred to reach a clinical pregnancy rate of 18.1% and a live birth rate of 16.7%. In conclusion, the intermittent vaginal administration of gonadotropins proved to be effective in POR women for their IVF treatments.

摘要

对于卵巢反应不良(POR)的女性而言,在体外受精(IVF)过程中获取足够的卵母细胞是一项挑战。我们采用了首次子宫首过效应的特点,这是我们率先在接受IVF治疗的女性中采用阴道给予促性腺激素的方法。在我们之前采用阴道给药的研究中,已证明促性腺激素吸收更快且消除更慢,并且女性受试者呈现出适当的卵巢卵泡生长和妊娠率。在本研究中,在2016年至2020年期间,266名POR女性每三天经阴道给予300至675 IU促性腺激素进行控制性卵巢刺激(COH)。注射时,针头以15 - 30°角朝向双侧阴道壁的中上部,注射深度为1 - 2毫米。对于COH结果,这些女性平均接受3.0±0.9次阴道注射,促性腺激素总剂量为1318.4±634.4 IU,产生2.2±1.9个成熟卵母细胞和1.0±1.2个优质胚胎。在这些胚胎中,0.9±1.0个被移植,临床妊娠率达到18.1%,活产率为16.7%。总之,促性腺激素间歇性阴道给药被证明对POR女性的IVF治疗有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8f5/9025251/9601dcc0bfc6/pharmaceutics-14-00869-g001.jpg

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