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在DuoStim方案中,对体外受精反应低下的不孕女性进行卵巢内注射与皮下注射阿法科丽卵泡素的疗效比较

The efficacy of intraovarian versus subcutaneous corifollitropin alfa administration in DuoStim protocol for infertile women with low in vitro fertilization response.

作者信息

Keikha Fatemeh, Moghadam Firoozeh Rakhshani, Shoarishoar Seyedeh Shahed, Tarafdari Azadeh, Ghaemi Marjan

机构信息

Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

J Obstet Gynaecol Res. 2025 May;51(5):e16316. doi: 10.1111/jog.16316.

Abstract

BACKGROUND AND AIM

Infertility in women, particularly those with a poor response to in vitro fertilization (IVF), poses significant challenges in reproductive medicine. This study aimed to compare the effectiveness of intraovarian versus subcutaneous injection of corifollitropin alfa in the DuoStim protocol among infertile women exhibiting a poor response to IVF, with a specific focus on oocyte retrieval counts and quality.

MATERIALS AND METHODS

A total of 40 poorly responding infertile women were randomly assigned to two groups: 20 women received corifollitropin alfa via intraovarian injection, and 20 women received it via subcutaneous injection. Key demographic data, cycle duration, gonadotropin dosage, the number of oocytes retrieved, and oocyte quality (specifically Grade B oocytes) were assessed.

RESULTS

Demographic analyses revealed no significant differences between the two groups in terms of age (subcutaneous: 37.91 ± 6.11 years; intraovarian: 36.84 ± 5.42 years; p = 0.17) or weight (subcutaneous: 74.15 ± 10.51 kg; intraovarian: 78.24 ± 13.22 kg; p = 0.42). The number of oocytes retrieved during both phases did not significantly differ, but the intraovarian group yielded a notably higher number of Grade B oocytes during the follicular phase (p = 0.02). No significant differences were observed in cycle duration (p > 0.05) or the final dose of gonadotropins administered (p > 0.05).

CONCLUSION

The study revealed that intraovarian injection of corifollitropin alfa may enhance the quality of oocytes retrieved, particularly Grade B oocytes, in women with poor response to IVF under the DuoStim protocol, while both methods exhibited similar outcomes in terms of demographic factors, cycle duration, and gonadotropin dosage.

摘要

背景与目的

女性不孕症,尤其是那些对体外受精(IVF)反应不佳的患者,给生殖医学带来了重大挑战。本研究旨在比较在DuoStim方案中,对IVF反应不佳的不孕女性进行卵巢内注射与皮下注射科丽卵泡素α的有效性,特别关注卵母细胞采集数量和质量。

材料与方法

总共40名反应不佳的不孕女性被随机分为两组:20名女性通过卵巢内注射接受科丽卵泡素α,20名女性通过皮下注射接受。评估关键人口统计学数据、周期持续时间、促性腺激素剂量、采集的卵母细胞数量和卵母细胞质量(特别是B级卵母细胞)。

结果

人口统计学分析显示,两组在年龄(皮下注射组:37.91±6.11岁;卵巢内注射组:36.84±5.42岁;p = 0.17)或体重(皮下注射组:74.15±10.51千克;卵巢内注射组:78.24±13.22千克;p = 0.42)方面无显著差异。两个阶段采集的卵母细胞数量无显著差异,但卵巢内注射组在卵泡期产生的B级卵母细胞数量明显更多(p = 0.02)。在周期持续时间(p>0.05)或最终给予的促性腺激素剂量(p>0.05)方面未观察到显著差异。

结论

该研究表明,在DuoStim方案下,对于IVF反应不佳的女性,卵巢内注射科丽卵泡素α可能会提高采集的卵母细胞质量,特别是B级卵母细胞,而两种方法在人口统计学因素、周期持续时间和促性腺激素剂量方面表现出相似的结果。

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