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在拮抗剂辅助生殖技术周期中联合使用促性腺激素释放激素激动剂与绒毛膜促性腺激素:近期证据的综述

Using GnRH agonists in combination with hCG in antagonist ART cycles: A SCOPING Review of recent evidences.

作者信息

Singh Neeta, Kashyap Aryan, Patel Garima, Vatsa Richa

机构信息

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

JBRA Assist Reprod. 2023 Aug 14;27(4):717-26. doi: 10.5935/1518-0557.20230029.

Abstract

Assisted Reproductive technology encompasses all techniques involving ovarian stimulation to produce high-quality oocytes and manipulation of both oocytes and sperm in vitro to produce embryos for the purpose of reproduction. The final maturation of oocytes induced by a "trigger" is a crucial step with the potential to affect in vitro fertilization outcomes. Human chorionic gonadotropin has traditionally been used as a substitute for luteinizing hormone to induce final oocyte maturation and meiosis. However, this practice may cause a potentially fatal iatrogenic complication known as ovarian hyperstimulation syndrome, which can cause significant morbidity and, in rare cases, death in otherwise healthy women. Thus, gonadotropin releasing hormone agonists have been promoted as a safer alternative for inducing oocyte maturation, albeit at the expense of luteal phase defect. Since then, various combinations of gonadotropin releasing hormone agonists and human chorionic gonadotropin have been tried. This scoping review evaluates these trigger combinations in various types of responders.

摘要

辅助生殖技术涵盖所有涉及卵巢刺激以产生高质量卵母细胞以及在体外对卵母细胞和精子进行操作以产生用于生殖目的胚胎的技术。由“扳机药物”诱导的卵母细胞最终成熟是一个关键步骤,有可能影响体外受精结果。传统上,人绒毛膜促性腺激素被用作促黄体生成素的替代品来诱导卵母细胞最终成熟和减数分裂。然而,这种做法可能会导致一种潜在致命的医源性并发症,即卵巢过度刺激综合征,这可能会导致严重的发病情况,在极少数情况下,还会导致原本健康的女性死亡。因此,促性腺激素释放激素激动剂已被推广为诱导卵母细胞成熟的更安全替代品,尽管会出现黄体期缺陷。从那时起,人们尝试了促性腺激素释放激素激动剂和人绒毛膜促性腺激素的各种组合。本综述评估了这些扳机药物组合在各类反应者中的情况。

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本文引用的文献

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ESHRE guideline: ovarian stimulation for IVF/ICSI.ESHRE指南:体外受精/卵胞浆内单精子注射的卵巢刺激
Hum Reprod Open. 2020 May 1;2020(2):hoaa009. doi: 10.1093/hropen/hoaa009. eCollection 2020.
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Advances in ovulation trigger strategies.排卵触发策略的进展。
Panminerva Med. 2019 Mar;61(1):42-51. doi: 10.23736/S0031-0808.18.03537-1.

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