Harvey Alexandra J, Willson Bryn E, Surrey Eric S, Gardner David K
Melbourne IVF, East Melbourne, Victoria, Australia; School of BioSciences, University of Melbourne, Parkville, Victoria, Australia.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cedars Sinai, Los Angeles, California.
Fertil Steril. 2025 Jan;123(1):10-21. doi: 10.1016/j.fertnstert.2024.08.340. Epub 2024 Aug 27.
Ovarian stimulation (OS) truly is an art. There exists a myriad of protocols used to achieve the same goal: stimulating the ovaries to produce more than one mature oocyte to improve the chance of a live birth. However, considerable debate remains as to whether OS impacts oocyte and endometrial quality to affect in vitro fertilization outcomes. Although "more is better" has long been considered the best approach for oocyte retrieval, this review challenges that notion by examining the influence of stimulation on oocyte quality. Likewise, improved outcomes after frozen blastocyst transfer suggest that OS perturbs endometrial preparation and/or receptivity, although correlating changes with implantation success remains a challenge. Therefore, the focus of this review is to summarize our current understanding of perturbations in human oocyte quality and endometrial function induced by exogenous hormone administration. We highlight the need for further research to identify more appropriate markers of oocyte developmental competence as well as those that define the roles of the endometrium in the success of assisted reproductive technology.
卵巢刺激（OS）确实是一门艺术。为了实现同一个目标，存在着无数种方案：刺激卵巢产生不止一个成熟卵母细胞，以提高活产几率。然而，关于卵巢刺激是否会影响卵母细胞和子宫内膜质量从而影响体外受精结局，仍存在大量争议。尽管长期以来“越多越好”一直被视为获取卵母细胞的最佳方法，但本综述通过研究刺激对卵母细胞质量的影响，对这一观念提出了挑战。同样，冷冻囊胚移植后改善的结局表明，卵巢刺激会扰乱子宫内膜准备和/或接受性，尽管将相关变化与着床成功联系起来仍然是一项挑战。因此，本综述的重点是总结我们目前对外源性激素给药引起的人类卵母细胞质量和子宫内膜功能紊乱的理解。我们强调需要进一步研究，以确定更合适的卵母细胞发育能力标志物，以及那些确定子宫内膜在辅助生殖技术成功中作用的标志物。
