IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Assist Reprod Genet. 2024 Jul;41(7):1863-1870. doi: 10.1007/s10815-024-03138-1. Epub 2024 May 20.
To investigate treatment approaches for fertility preservation patients, with a focus on timing of oocyte retrieval, and to determine whether their characteristics differ from those of other IVF patients. Additionally, to evaluate the significance of follicle size on triggering day in the context of fertility preservation.
This retrospective cohort study was conducted in a tertiary, university-affiliated medical center. It compared 140 matched patients undergoing social fertility preservation to 140 patients undergoing IVF treatment due to male factor infertility.
Patients undergoing fertility preservation received a higher initial gonadotropin dose and had more oocytes retrieved than the control group. Within the fertility preservation cohort, a negative correlation was observed between the rate of large follicles and the number of retrieved oocytes. While there was no significant association between rate of large follicles and oocyte maturation rate in the entire group, age-stratified analysis revealed a negative relationship. Analysis revealed that although traditional treatment determinants such as follicular size and gonadotropin dosing were considered, peak estradiol levels were consistently identified as significant predictors of treatment outcomes.
Physicians may modify treatments for fertility preservation, emphasizing a higher gonadotropin dosage to maximize oocyte retrieval. Elevated estradiol levels can serve as a real-time predictive marker for the number of mature oocytes. While treatment strategies can influence outcomes, intrinsic patient factors, particularly baseline ovarian function, remain crucial. These results challenge beliefs regarding the importance of larger follicles and suggest the need for a tailored approach, considering patient age and specific fertility preservation objectives.
探讨生育力保存患者的治疗方法，重点关注卵母细胞采集的时机，并确定其特征是否与其他 IVF 患者不同。此外，评估在生育力保存背景下触发日卵泡大小的意义。
本回顾性队列研究在一家三级大学附属医院进行。它比较了 140 名因社会因素进行生育力保存的匹配患者和 140 名因男性因素不孕进行 IVF 治疗的患者。
接受生育力保存的患者接受的初始促性腺激素剂量更高，采集的卵母细胞数量也更多。在生育力保存队列中，大卵泡率与采集的卵母细胞数量之间存在负相关。虽然整个组中没有大卵泡率和卵母细胞成熟率之间的显著相关性，但年龄分层分析显示出负相关。分析表明，尽管考虑了传统的治疗决定因素，如卵泡大小和促性腺激素剂量，但峰值雌二醇水平始终被确定为治疗结果的显著预测因子。
医生可能会修改生育力保存的治疗方法，强调使用更高剂量的促性腺激素以最大限度地采集卵母细胞。升高的雌二醇水平可以作为预测成熟卵母细胞数量的实时标志物。虽然治疗策略可以影响结果，但内在的患者因素，特别是基线卵巢功能，仍然至关重要。这些结果挑战了关于大卵泡重要性的观念，并表明需要根据患者年龄和特定的生育力保存目标采用个体化方法。
