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[体外受精程序中解冻胚胎移植后功能性腺功能不全女性妊娠的激素替代——胎盘功能不全问题]

[Hormone replacement for pregnancy in functionally agonadal women after transfer of thawed embryos in the in vitro fertilization program--problems of placental incompetence].

作者信息

Mardesic T, Hulvert J, Miková M, Müller P, Voboril J, Hüttelová R, Becvárová V

机构信息

Sanatorium Pronatal, Praha.

出版信息

Ceska Gynekol. 1998 Oct;63(5):402-5.

PMID:9818499
Abstract

Experience with hormonal substitution of sterile women treated within the IVF programme by means of donated oocytes changed completely views on endocrinological prerequisites of successful implantations and the further development of early pregnancy. While the effect of oestrogens and progesterone on endometrial proliferation and receptivity has been elaborated in great detail in the literature, data on the substitution of early pregnancy and the onset of placental competence are much scarcer. 1. The placenta is during the 15th week of pregnancy already fully competent and hormonal substitution can be probably terminated already sooner. 2. From the shape of the curves (as compared with steroid levels in spontaneous pregnancies) the authors conclude that the used doses (in particular of progesterone were higher than physiological. 3. Pregnancy of women with primary or secondary ovarian failure is an ideal in vivo model for investigation of the receptivity of the endometrium, the problem of implantation and function of the foetoplacental unit. Available data are not uniform and therefore in this very interesting field further investigations are needed.

摘要

通过捐赠卵母细胞在体外受精项目中治疗不育女性的激素替代经验,彻底改变了人们对成功着床的内分泌学先决条件以及早期妊娠进一步发展的看法。虽然雌激素和孕激素对子宫内膜增殖和接受性的影响在文献中已有详细阐述,但关于早期妊娠替代和胎盘功能开始的数据却少得多。1. 在妊娠第15周时胎盘已完全具备功能,激素替代可能更早就能终止。2. 从曲线形状(与自然妊娠中的类固醇水平相比)来看,作者得出结论,所使用的剂量(尤其是孕激素)高于生理剂量。3. 原发性或继发性卵巢功能衰竭女性的妊娠是研究子宫内膜接受性、着床问题和胎儿 - 胎盘单位功能的理想体内模型。现有数据并不一致,因此在这个非常有趣的领域需要进一步研究。

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