Centre for Reproductive Medicine, Henan Province Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.
BMC Pregnancy Childbirth. 2023 Mar 15;23(1):178. doi: 10.1186/s12884-023-05477-w.
Resistant ovarian syndrome(ROS) is a rare disease. It is difficult to diagnose and treat. Most of the literature reports on assisted pregnancy treatment for ROS patients are individual case reports. In this paper, the ovulation stimulation protocol and assisted pregnancy process of ROS infertile patients in our reproductive center were summarized and analyzed to provide information and support for the clinical treatment of ROS patients.
From January 2017 to March 2022, assisted reproductive technology treatments and clinical characteristics parameters of six patients with ROS were retrospectively reviewed. Based on controlled ovarian stimulation protocols, these stimulation cycles were separated into four groups: Early-Follicular Phase Long-Acting Gonadotropin-Releasing Hormone Agonist Long Protocol (EFLL) group (n = 6), Progestin Primed Ovarian Stimulation(PPOS) protocol group (n = 5), mild-stimulation protocol group (n = 2), and Natural cycle protocol group (n = 3).
A total of 16 cycles of ovulation stimulation were carried out in 6 patients with ROS. A total of 19 oocytes were retrieved, as well as 13 MII oocytes, 11 two pronuclear(2PN) fertilized embryos, and 8 excellent embryos. The oocytes acquisition rate was 50% and the fertilization rate of 2PN was 57.9%, and the excellent embryo rate was 72.7%. The EFLL protocol obtained 17 oocytes, 12 MII oocytes, 11 2PN fertilized embryos, and 8 excellent embryos; the mild-stimulation protocol obtained 1 oocyte; the Natural cycle protocol obtained 1 oocyte, and oocytes were not matured after in vitro maturation (IVM); the PPOS protocol obtained no oocytes. Compared with three other protocols, The fertilization rate of 2PN (64.7%) and excellent embryo rate (72.7%) in the EFLL protocol were higher than those of other protocols(0%). Two fresh cycle embryo transfers resulted in live births, while two frozen-thawed embryo transfer cycles resulted in one live birth and one clinical pregnancy using the EFLL protocol.
Although the current study is based on a small sample of participants, the findings suggest that the EFLL protocol can be employed for ovarian stimulation and may result in a live birth in ROS patients.
耐药卵巢综合征（ROS）是一种罕见疾病，其诊断和治疗都具有一定难度。大多数关于 ROS 患者辅助妊娠治疗的文献报道都是个案报告。本文总结和分析了我院生殖中心 ROS 不孕患者的促排卵方案和辅助妊娠过程，为 ROS 患者的临床治疗提供信息和支持。
回顾性分析 2017 年 1 月至 2022 年 3 月我院生殖中心 6 例 ROS 不孕患者的接受辅助生殖技术治疗的临床资料，对其临床特征参数进行分析。根据控制性卵巢刺激方案将这些刺激周期分为 4 组：早卵泡期长效促性腺激素释放激素激动剂长方案（EFLL）组（n=6）、孕激素预处理促排卵（PPOS）方案组（n=5）、微刺激方案组（n=2）和自然周期方案组（n=3）。
6 例 ROS 患者共进行了 16 个促排卵周期，共获得 19 枚卵子，其中 13 枚 MII 卵子，11 枚 2 原核（2PN）受精胚胎，8 枚优质胚胎。获卵率为 50%，2PN 受精率为 57.9%，优质胚胎率为 72.7%。EFLL 方案获得 17 枚卵子，12 枚 MII 卵子，11 枚 2PN 受精胚胎，8 枚优质胚胎；微刺激方案获得 1 枚卵子，体外成熟（IVM）后未成熟；PPOS 方案未获得卵子；自然周期方案获得 1 枚卵子。与其他 3 种方案相比，EFLL 方案的 2PN 受精率（64.7%）和优质胚胎率（72.7%）较高。2 例新鲜周期胚胎移植后均获得临床妊娠，EFLL 方案冻融胚胎移植 2 例，获得 1 例临床妊娠。
尽管本研究基于小样本参与者，但结果表明 EFLL 方案可用于 ROS 患者的卵巢刺激，并可能导致 ROS 患者获得活产。
