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单独使用生长激素作为辅助治疗对高龄且体重指数(BMI)≥24kg/m²、因胚胎质量差导致体外受精失败患者的益处。

The Advantage of Growth Hormone Alone as an Adjuvant Therapy in Advanced Age and BMI ≥ 24 kg/m with In Vitro Fertilization Failure Due to Poor Embryo Quality.

作者信息

Jiang Shuyi, Fu Lingjie, Zhang Wei, Zuo Na, Guan Wenzheng, Sun Hao, Wang Xiuxia

机构信息

Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 36 SanHao Street, Shenyang 110004, China.

Department of Clinical Epidemiology and Evidence-Based Medicine, the First Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, China.

出版信息

J Clin Med. 2023 Jan 26;12(3):955. doi: 10.3390/jcm12030955.

DOI:10.3390/jcm12030955
PMID:36769605
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9918017/
Abstract

This study aimed to assess the effects of GH adjuvant therapy on the cumulative live birth rate in patients with poor embryo quality and to determine the characteristics of patients who are more responsive to GH. A retrospective cohort study was carried out in patients who have suffered from previous IVF failure due to poor embryonic development and underwent IVF with or without a 6-week pretreatment with GH in the subsequent cycle from January 2018 to December 2020. Clinical parameters including the cumulative live birth rate between the (-) GH and (+) GH groups were compared. Multivariate analysis was performed to ascertain associations between clinical parameters and cumulative live birth rate. Upon analysis of the clinical data from 236 IVF cycles, 84 patients received GH and 152 did not receive GH. In frozen embryo transfer cycles, compared with the (-) GH group, the implantation rate and live birth rate were significantly higher in the (+) GH group ( < 0.05). After adjusting for possible confounding factors, GH improved cumulative live birth per oocyte retrieval cycle by 1.96 folds ( = 0.032). Furthermore, when patients were subdivided based on age and BMI, a significant increase in the cumulative live birth rate was found in the (+) GH group of patients between 35 and 42 years old and BMI ≥ 24 kg/m, respectively ( < 0.05). GH may increase the live birth rate in women who experienced IVF failure because of poor embryonic development, particularly in obese patients and women with advanced age.

摘要

本研究旨在评估生长激素(GH)辅助治疗对胚胎质量差的患者累积活产率的影响,并确定对GH反应更敏感的患者特征。对2018年1月至2020年12月期间因胚胎发育不良而先前体外受精(IVF)失败,随后周期接受或未接受为期6周GH预处理进行IVF的患者开展了一项回顾性队列研究。比较了包括(-)GH组和(+)GH组之间累积活产率在内的临床参数。进行多因素分析以确定临床参数与累积活产率之间的关联。在分析236个IVF周期的临床数据时,84例患者接受了GH,152例未接受GH。在冻融胚胎移植周期中,与(-)GH组相比,(+)GH组的着床率和活产率显著更高(<0.05)。在调整可能的混杂因素后,GH使每个取卵周期的累积活产率提高了1.96倍(=0.032)。此外,当根据年龄和体重指数对患者进行细分时,分别在35至42岁且体重指数≥24kg/m²的(+)GH组患者中发现累积活产率显著增加(<0.05)。GH可能会提高因胚胎发育不良而经历IVF失败的女性的活产率,尤其是肥胖患者和高龄女性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d07/9918017/f15b86f30c0f/jcm-12-00955-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d07/9918017/8b7aa1dfa719/jcm-12-00955-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d07/9918017/f15b86f30c0f/jcm-12-00955-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d07/9918017/8b7aa1dfa719/jcm-12-00955-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d07/9918017/f15b86f30c0f/jcm-12-00955-g002.jpg

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本文引用的文献

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Non-invasive oocyte quality assessment.非侵入性卵母细胞质量评估。
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Growth hormone for in vitro fertilisation (IVF).促性腺激素在体外受精(IVF)中的应用。
Cochrane Database Syst Rev. 2021 Nov 22;11(11):CD000099. doi: 10.1002/14651858.CD000099.pub4.
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Oocyte quality and aging.卵母细胞质量与衰老。
JBRA Assist Reprod. 2022 Jan 17;26(1):105-122. doi: 10.5935/1518-0557.20210026.
4
Growth hormone protects against ovarian granulosa cell apoptosis: Alleviation oxidative stress and enhancement mitochondrial function.生长激素可防止卵巢颗粒细胞凋亡:减轻氧化应激和增强线粒体功能。
Reprod Biol. 2021 Jun;21(2):100504. doi: 10.1016/j.repbio.2021.100504. Epub 2021 Apr 8.
5
Growth hormone ameliorates the age-associated depletion of ovarian reserve and decline of oocyte quality via inhibiting the activation of Fos and Jun signaling.生长激素通过抑制 Fos 和 Jun 信号的激活,改善与年龄相关的卵巢储备耗竭和卵母细胞质量下降。
Aging (Albany NY). 2021 Feb 17;13(5):6765-6781. doi: 10.18632/aging.202534.
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Effect of Age and Embryo Morphology on Live Birth Rate After Transfer of Unbiopsied Blastocysts.未活检囊胚移植后年龄和胚胎形态对活产率的影响。
JBRA Assist Reprod. 2021 Jul 21;25(3):373-382. doi: 10.5935/1518-0557.20200101.
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Efficacy of growth hormone supplementation with ultrashort GnRH antagonist in IVF/ICSI for poor responders; randomized controlled trial.超短 GnRH 拮抗剂联合生长激素在 IVF/ICSI 中对卵巢低反应患者的疗效:一项随机对照试验。
Taiwan J Obstet Gynecol. 2021 Jan;60(1):51-55. doi: 10.1016/j.tjog.2020.10.003.
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GHR signalling: Receptor activation and degradation mechanisms.生长激素信号转导:受体激活和降解机制。
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