Kontogeorgi Adamantia, Tsangkalova Gkalia, Ambatzi Panagiota, Boutas Ioannis, Meridis Eleftherios, Gryparis Ioannis, Kalaitzis Dimitrios, Fenga Angeliki, Peppa Melpomeni, Kalantaridou Sophia, Makrigiannakis Antonios, Paschopoulos Minas
School of Medicine, University of Crete, 710 03 Heraklion, Greece.
IVFSerum Advanced IVF Treatment Center, 141 23 Likovrisi, Greece.
Life (Basel). 2025 Aug 4;15(8):1235. doi: 10.3390/life15081235.
: This retrospective observational study evaluated the efficacy and safety of an ovarian stimulation protocol for embryo banking that involves continuous administration of clomiphene citrate (CC) in combination with gonadotropins, without the use of GnRH antagonists. : Conducted at the Serum IVF Clinic in Athens, Greece, the study included 250 women aged 25-45 who underwent IVF for embryo banking. The protocol involved administering 150 mg of CC daily from day 2 of the menstrual cycle until the day before hCG trigger, alongside 150 IU/day of Meriofert. Outcomes assessed included oocyte yield, fertilization rates, incidence of ovarian hyperstimulation syndrome (OHSS), and hormonal correlations. Comparative and regression analyses explored differences between age groups and predictors of success. : The protocol demonstrated a favorable safety profile with no cases of OHSS and yielded a mean of 10.25 oocytes per patient. Group analysis showed significantly more oocytes retrieved in women under 40 (mean: 12.5) versus those over 40 (mean: 8.43), while fertilization rates were paradoxically higher in the older cohort (59.16% vs. 30.68%, < 0.0001). Regression models revealed basal FSH to be a significant inverse predictor of oocyte yield, but it was positively associated with fertilization rate. Continuous CC use effectively suppressed premature LH surges without compromising oocyte or embryo quality, allowing flexible and cost-effective stimulation with minimal monitoring. : Continuous administration of clomiphene citrate in combination with gonadotropins presents a promising, antagonist-free ovarian stimulation protocol for embryo banking. The approach is economically efficient, reduces monitoring requirements, and maintains safety and effectiveness and is particularly notable in women over 40. Further studies are warranted to validate these findings and refine protocol mechanisms.
这项回顾性观察研究评估了一种用于胚胎冷冻保存的卵巢刺激方案的疗效和安全性，该方案包括连续给予枸橼酸氯米芬（CC）联合促性腺激素，且不使用GnRH拮抗剂。该研究在希腊雅典的血清试管婴儿诊所进行，纳入了250名年龄在25至45岁之间因胚胎冷冻保存而接受试管婴儿治疗的女性。该方案包括从月经周期第2天开始每天服用150毫克CC直至hCG注射前一天，同时每天注射150国际单位的Meriofert。评估的结果包括卵母细胞产量、受精率、卵巢过度刺激综合征（OHSS）的发生率以及激素相关性。比较分析和回归分析探讨了年龄组之间的差异以及成功的预测因素。该方案显示出良好的安全性，无OHSS病例，每位患者平均获得10.25个卵母细胞。分组分析显示，40岁以下女性（平均：12.5个）回收的卵母细胞明显多于40岁以上女性（平均：8.43个），而令人惊讶的是，年龄较大的队列受精率更高（59.16%对30.68%，<0.0001）。回归模型显示基础FSH是卵母细胞产量的显著反向预测因子，但它与受精率呈正相关。持续使用CC可有效抑制过早的LH峰，同时不影响卵母细胞或胚胎质量，允许进行灵活且经济高效的刺激，监测需求最小。连续给予枸橼酸氯米芬联合促性腺激素为胚胎冷冻保存提供了一种有前景的、无拮抗剂的卵巢刺激方案。该方法经济高效，减少了监测需求，并保持了安全性和有效性，在40岁以上女性中尤为显著。有必要进行进一步研究以验证这些发现并完善方案机制。
