根据 ESHRE 和 ASRM 指南，如何为第一个授精周期进行卵泡刺激素 delta 剂量调整；一项回顾性队列研究。

How to dose follitropin delta for the first insemination cycle according to the ESHRE and ASRM guidelines; a retrospective cohort study.

机构信息

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility Center, McGill University, 888 Boulevard de Maisonneuve East, Suit # 200, Montreal, QC, H2l 4S8, Canada.

Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada.

出版信息

J Ovarian Res. 2023 Jan 27;16(1):24. doi: 10.1186/s13048-022-01079-w.

DOI:10.1186/s13048-022-01079-w

PMID:36707880

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9883945/

Abstract

BACKGROUND

Follitropin Delta (FD) is indicated exclusively for in-vitro fertilization however, being a gonadotropin it could be used for other purposes. A dosing algorithm exists for FD and IVF but is needed for intrauterine insemination (IUI) cycles. The objective of this study is to determine dosing for FD for the first controlled ovarian hyperstimulation (COH) cycle according to current stimulation guidelines.

RESULTS

A retrospective study of 157 subjects from a single university fertility center from January 2017 to March 2020, was performed. All patients stimulated with FD for IUI were included. The number of failed, normal, or overstimulation cycles was determined based on stimulating not more than 2 mature follicles. We then stratified the group based on the AFC, AMH, and body weight. Of 157 subjects, 49% stimulated correctly, 5.6% failed and 45.4% overstimulated. An analysis of the COH IUI cycles based on stratification and over or lack of stimulation per published guidelines found that women with a bodyweight < 80 kg or AMH ≥ 1.5 ng/ml or AFC ≥ 10 initially stimulate with FD 2.0 to 3.0mcg daily. For women with an AFC of 6-9 stimulate with Follitropin Delta 3.0mcg daily. For women with an AFC < 6 or serum AMH < 1.5 ng/ml stimulate with FD 3.0-4.0mcg daily. For women with body weight > 80 kg stimulate initially with daily with 4.0-6.0mcg FD.

CONCLUSIONS

Follitropin Delta can be used safely for controlled ovarian stimulation and insemination at doses easily dispensed by the current methods of delivery, within the current published guidelines for follicle development.

摘要

背景

Follitropin Delta（FD）仅用于体外受精，但作为一种促性腺激素，它也可用于其他用途。目前已经有用于 FD 和 IVF 的剂量算法，但需要用于宫内授精（IUI）周期。本研究的目的是根据当前的刺激指南，确定 FD 在第一个控制性卵巢过度刺激（COH）周期中的剂量。

结果

对 2017 年 1 月至 2020 年 3 月期间来自单一大学生育中心的 157 名患者进行了回顾性研究。所有接受 FD 刺激进行 IUI 的患者均包括在内。根据刺激不超过 2 个成熟卵泡的情况，确定了失败、正常或过度刺激周期的数量。然后根据 AFC、AMH 和体重对该组进行分层。在 157 名患者中，49%的患者刺激正确，5.6%的患者刺激失败，45.4%的患者过度刺激。根据发表的指南对 COH IUI 周期进行的分层和过度或缺乏刺激的分析发现，体重<80kg 或 AMH≥1.5ng/ml 或 AFC≥10 的女性最初每天用 FD 2.0 至 3.0mcg 刺激。对于 AFC 为 6-9 的女性，每天用 Follitropin Delta 3.0mcg 刺激。对于 AFC<6 或血清 AMH<1.5ng/ml 的女性，每天用 FD 3.0-4.0mcg 刺激。对于体重>80kg 的女性，最初每天用 4.0-6.0mcg FD 刺激。