Karimi Rana, Hadavi Farnaz, Jafarabadi Mina
Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Arch Gynecol Obstet. 2025 Jan;311(1):175-182. doi: 10.1007/s00404-024-07895-3. Epub 2024 Dec 21.
This study aimed to evaluate the effect of Pyridostigmine on IGF-1 and GH levels and the outcomes of COS cycles in women with POR.
A total of 110 eligible women were randomly allocated to Pyridostigmine (n: 55) and control (n: 55) groups. COS outcomes, including gonadotrophin doses, COS duration, cycle cancellation rate, number of retrieved oocytes, number of MII oocytes, and fertilization rate, were compared between the groups. Also, IGF-1 and GH levels were measured at three time points: baseline, on the 5th day of the cycle, and on the trigger day.
A total of 92 participants (Pyridostigmine: 44, Control: 48) were included in the final analysis. The Pyridostigmine group required significantly lower gonadotrophin doses (P < 0.0022) and had a shorter COS duration (P = 0.0019). No significant differences were observed in cycle cancellation rate, number of retrieved oocytes, number of MII oocytes, or fertilization rate. Pyridostigmine significantly accelerated GH levels over time compared to the Control group, with larger mean differences observed at each time point. The interaction between time and group indicated that the effect of the intervention on GH levels varied over the course of the COS cycle. Specifically, the intervention augmented the effect of COS agents on GH levels, as evidenced by the higher GH levels observed in the intervention group compared to the control group. For IGF-1 levels, time had a highly significant effect (P < 0.0001), but the interaction between Time and Group was not significant (P = 0.5067). Mean IGF-1 levels were higher in the Pyridostigmine group, though not statistically significant.
Pyridostigmine improved COS efficiency by reducing gonadotrophin doses and COS duration. Further research is needed to explore its potential benefits in enhancing ovarian response in women with POR.
Iranian Registry of Clinical Trials (IRCT). Registration date: 2023-08-05, Registration number: IRCT20100518003950N8.
本研究旨在评估吡啶斯的明对POR女性胰岛素样生长因子-1（IGF-1）和生长激素（GH）水平以及促排卵周期结局的影响。
总共110名符合条件的女性被随机分配到吡啶斯的明组（n = 55）和对照组（n = 55）。比较两组的促排卵结局，包括促性腺激素剂量、促排卵持续时间、周期取消率、取卵数、MII期卵母细胞数和受精率。此外，在三个时间点测量IGF-1和GH水平：基线、周期第5天和扳机日。
最终分析纳入了总共92名参与者（吡啶斯的明组：44名，对照组：48名）。吡啶斯的明组所需的促性腺激素剂量显著更低（P < 0.0022），促排卵持续时间更短（P = 0.0019）。在周期取消率、取卵数、MII期卵母细胞数或受精率方面未观察到显著差异。与对照组相比，吡啶斯的明随时间显著加速了GH水平升高，在每个时间点观察到更大的平均差异。时间与组之间的交互作用表明，干预对GH水平的影响在促排卵周期过程中有所不同。具体而言，干预增强了促排卵药物对GH水平的作用，干预组的GH水平高于对照组证明了这一点。对于IGF-1水平，时间有高度显著的影响（P < 0.0001），但时间与组之间的交互作用不显著（P = 0.5067）。吡啶斯的明组的平均IGF-1水平更高，尽管无统计学意义。
吡啶斯的明通过降低促性腺激素剂量和促排卵持续时间提高了促排卵效率。需要进一步研究以探索其在增强POR女性卵巢反应方面的潜在益处。
伊朗临床试验注册中心（IRCT）。注册日期：2023年8月5日，注册号：IRCT20100518003950N8。
