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优化多囊卵巢综合征患者体外受精的卵巢刺激:一种新型的第1天促性腺激素释放激素拮抗剂方案。

Optimizing Ovarian Stimulation for IVF in PCOS Patients: A Novel Day 1 GnRH Antagonist Protocol.

作者信息

Ghosh Dastidar Sudarsan, Ghosh Dastidar Biswanath, Chattopadhyay Ratna, Chakraborty Chandan

机构信息

GD Institute for Fertility Research, 36 A/1 S.P. Mukherjee Road, Kolkata 700025, West Bengal, India.

Department of Obstetrics and Gynecology & GDIFR-IPGMER Center of Excellence (COE) in Assisted Reproductive Technology (ART), Institute of Post-Graduate Medical Education and Research (IPGMER) & SSKM Hospital, 244 AJC Bose Road, Kolkata 700020, West Bengal, India.

出版信息

J Clin Med. 2025 Aug 21;14(16):5901. doi: 10.3390/jcm14165901.

Abstract

: Gonadotropin-releasing hormone (GnRH) antagonist protocols are preferred in polycystic ovary syndrome (PCOS) patients undergoing in vitro fertilization (IVF) as they provide the best combination of flexibility, acceptable outcomes, and safety. Numerous studies have compared outcomes between GnRH agonist long protocol and standard flexible antagonist protocol. However, there are scant studies investigating the effectiveness of antagonist administration from day 1 of ovarian stimulation in PCOS patients. : We performed a retrospective cohort study to compare laboratory and clinical outcomes in IVF between standard flexible day 5/day 6 versus day 1 GnRH antagonist protocol in PCOS patients. : Our data indicates significantly superior oocyte yield and top-quality embryo proportion in patients with antagonists from day 1. Cumulative clinical pregnancy rates also tended to be superior in this group. : Our findings indicate that administration of GnRH antagonists from day 1 of stimulation in PCOS patients undergoing IVF may lead to superior results.

摘要

促性腺激素释放激素(GnRH)拮抗剂方案在接受体外受精(IVF)的多囊卵巢综合征(PCOS)患者中更受青睐,因为它们在灵活性、可接受的结果和安全性方面提供了最佳组合。许多研究比较了GnRH激动剂长方案和标准灵活拮抗剂方案之间的结果。然而,很少有研究调查在PCOS患者中从卵巢刺激第1天开始使用拮抗剂的有效性。:我们进行了一项回顾性队列研究,以比较PCOS患者在标准灵活的第5天/第6天与第1天GnRH拮抗剂方案的IVF中的实验室和临床结果。:我们的数据表明,从第1天开始使用拮抗剂的患者的卵母细胞产量和优质胚胎比例明显更高。该组的累积临床妊娠率也往往更高。:我们的研究结果表明,在接受IVF的PCOS患者中,从刺激第1天开始使用GnRH拮抗剂可能会带来更好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96b5/12387123/b06e14dc639a/jcm-14-05901-g001.jpg

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