黄体期雌激素预处理对卵泡次优反应且Gn启动日卵泡发育不同步患者IVF结局的影响.pdf

该【黄体期雌激素预处理对卵泡次优反应且Gn启动日卵泡发育不同步患者IVF结局的影响 】是由【学习一点】上传分享，文档一共【5】页，该文档可以免费在线阅读，需要了解更多关于【黄体期雌激素预处理对卵泡次优反应且Gn启动日卵泡发育不同步患者IVF结局的影响 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。:..·376·??????2023?3??32??3?DOI:.1004‐?????????????????Gn????????????IVF????????,???,???,??,??*(??????????????901????????,??230031)【??】???????????????????)Gn(???????????????????IVF?????。???????2018?1??2022?1??Ч??????????/?????????‐????(IVF/ICSI‐ET)??????????Gn?????????????????,???????????????????????(?=158)?????????(???,?=84),б??????????、????????????。???????????、????、?????(BMI)、????(FSH、LH、E2)??、??????(bAFC)、??????(AMH)??、Gn??、HCG?????????、???、???、???、?????、?????、???E2?P?????????(?>)。?????б,????????Gn??????[(±)Uvs.(±)U,?<],HCG?LH??????[(±)U/Lvs.(±)U/L,?<]。???????????、?????、?????????????????(??>),??????б,?????????????、?????????????????????Gn?,??????????,?σ??????。?????????,???????????,?????????????IVF?,???????????。【???】?????????;??????;????【?????】【?????】A???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????‐??,????????‐???,???????‐???,?????,????????*????????????????????????????,???901????????????????????????????????????????,????230031????????【????????】?????????:esinpatientswithsuboptimalfollicularresponseandasynchronousfolliculardevelopmentongonadotropin(Gn)initiationday.???????:TheclinicaldataofIVF/ICSI‐:estrogenpretreatmentgroup(?=158)andcontrolgroup(withoutestrogenpretreatment)(?=84),ovulationinductionparedbetweenthetwogroups.???????:Therewerenosignificantdifferencesinmeanage,infertilityyears,bodymassindex(BMI),basallevelsofFSH,LHandE2,basicantralfolliclecount(bAFC),anti‐Mullerianhormone(AMH),Gn【????】2022‐09‐14;【????】2022‐11‐01【????】ν??????????(1604a0802095)【????】???,?,ν????,??,??????.(*????,Email:jiangh105@):..??????2023?3??32??3?·377·days,therateofasynchronousfolliculardevelopmentonHCGday,numberofoocytesretrieved,fertilizationrate,cleavagerate,good‐qualityembryorate,blastocystformationrateandE2andprogesteronelevelsontriggerdaybetweenthetwogroups(?>).Comparedwiththecontrolgroup,totaldosesofGnwassignificantlyincreasedintheestrogenpretreatmentgroup[(±)Uvs.(±)U,?<]andLHlevelsonHCGdayweresignificantlydecreased[(±)U/Lvs.(±)U/L,?<].Therewerenosignificantdifferencesinclinicalpregnancyrate,implantationrate,earlymiscarriagerateandpersistentpregnancyratebetweenthetwogroups(?>).However,theclinicalpregnancyrate,embryoimplantationrateandcontinuouspregnancyrateoftheestrogenpretreatmentgrouphadanincreasingtrend,paredwiththecontrolgroup.???????????:Intheantagonistprotocol,estrogenpretreatmentinthelutealphasehasabeneficialesforthepatientswithsuboptimalovarianresponseandasynchronousfolliculardevelopmentonGninitiationday.????????:Estrogenpretreatmentinlutealphase;Ovariansuboptimalresponse;e(??????????2023,32(03):376‐380)?????(POR)?????????(Gn)2022?1?Ч????????????Gn?????????????,????????????????????IVF/ICSI‐ET????。????????、Gn???、??????、?????:(1)???????????[2]:???????????[1]。2016????????????(bAFC)5~12?、AMH≥,??????????????,????4~9??????????σ???4~9?;(2)Gn???[2]?????????。???(GnRH‐ant)?σ???????,???????????????[13]???????、?ь??、?????、?????≥3mm;(3)?????(BMI)??:18~28??Gn???,??????????????2kg/m;(4)??????≤2???,?????(OHSS)????,??????????????;(5)????σ?????σ;(6)??????[3‐4]。???????????????FSH???????。????????????)1(:????‐????????FSH?,?????????,???????????,??????????????????、????;(2)?2???????[5]?,????????????。????????????;(3)?????????????????????????,?????????????,???????、?????????、?????????х??、?????、??、???????、?????????????;(4)?????????[6‐9]。2015????????????,?????????????????。??????????????????????Ч?????242???,????????[10]Gn????。?????????????????????????????(?=158)??????????????????,????????(?=84)。[11‐12]????、??????Gn??。????????????????????????????????1.??????:????σ????????。Ч????????????Gn?????????7?????????(???,??,???????????,?????????????)4mg/d?Gn???。??????3~2?????:σ???????.2。???????IVF??????bAFC、????????BMI,??Gn100~?????225U/d????????(COS),????????、??????12~14mm?E2??>1101pmol/L?,????????,?????2018?1????????(???,?????,??):..·378·??????2023?3??32??3?????????。?2???????≥18mm?、?????、?????、?????。D3???3???????≥17mm?,??HCG(η?,???7~10??Ⅰ??Ⅱ???(7/Ⅰ~10/Ⅱ)?????,???)250μg,36~38h????????=??????。?????????????????。???????????,????????/?????×100%;???=?????2~3?????????,??????????/????×100%;???=????????????。?/?????×100%;?????=?????/3.????、?????????:?????????×100%;?????=?????????????????,???IVF?ICSI??。?/????????????×100%。????3?,??????????,??1~2?、??????D3???????。????????????????????????。?(???40mg/d,????20mg/d)。???????±???(?珔±?)??,??????4.???????????;???Ч??,HCG‐β????d14??:?б/?(%)??,?‐HCG>20U/L???,??HCG???????б???2??。?<??????????。βχ??;??30~35d???????,??????????????????????????,?12???????????。?、????????б??、?????????????、????、BMI、??????????????????;???FSH、LH、E2、bAFC、AMH??????????????、???、???、?????、????(?>)(?1)。??????????б?(?±?)????????????BMI/(kg/m2)??FSH/(U/L)???????±±±±???±±±±??????E2/(pmol/L)??LH/(U/L)AMH/(ng/ml)bAFC???????±±±±???±±±±??????7???????????Gn?б??????????、???????HCG?E2?P??????????,??????????????????;?(?>);????????Gn??????????????HCG??????????????,HCG?LH?????????(??<);?,??????????(?>)(?2)。???????????б?[(?±?),%]????HCG?LH/(U/L)HCG?E2/(pmol/L)HCG?P/(nmol/L)???????±*±±è膊铑???±±±è膊铑????Gn??Gn??/(U)HCG????????????????±±*(34/158)R#趑噰e槝拻???±±(24/84)R#趑噰e槝拻?:????б?,*?<。:..??????2023?3??32??3?·379·?、????????????????б??、?????、?????、?????、?????????????????????????????(?>),??б????????,?????????(?>);?,?????????????、?????????????、???、???、?????????????,????????????、?????、?????????、????(?3)。??????????????????б?[(?±?),%]??????????????????????????????????±(797/1106)(609/797)(334/797)(186/454)览亮哪煙鼢h敂忖s构烫眄???±(428/624)(313/428)(185/428)(87/217)览亮哪煙鼢h敂忖s构烫眄????????????????????????????????????????????/(mm)???????±±(41/91)(46/155)(10/41)(31/91)櫃妹帋Ё唵唵貂{挝???±±(19/53)(21/95)(8/19)(11/53)櫃妹帋Ё唵唵貂{挝??????,????Gn?????????????????σ??????,?????、???2016????????????、???С??????????,?????????[10](AFC、AMH)????????????????。???????????????????????,????С??(AFC≥5?,AMH≥???х????????????。2012??)、???????????4~9??????????IVF????????????[2]???????,???????????21?????“??????”??。???Б??????1???????,??4~9???????????????4mg????,????%[14]。??,?????????ART?????、?????,???????????????????????,???????????????????。?????????????????????,????????С????[18]??????????????。2013?????,?????σ、Gn???????????????????,??????????б,??????????????,?????????????????,???????????????,???????????????,??????,??????????[19]。[15]??????????????。?????????????????????,???????????????,????????????????????,??????Gn???????????????。????????,?????????????????36?????FSH?????????????,????BMI?????????[20]。2022??????????????????????,??????????????,??????????????,???????,??????。7????????2??????4mg/d????????,???????????????,???????????Gn??????,?????????????????FSH,х????、MⅡ??、???、??????????????????????,??????,??????????э[12]。2020?ESHRE????,???[16]??????。??,????????????????????????????????????FSH?LH??,???????FSH????,?????????????????[11]。??,?????????????[17]。2015???????σ???????????,??????????????,??????????????????,??????????、?:..·380·??????2023?3??32??3??????、??、???????????。Ч?protocolsforwomenundergoingassistedreproductivetechniques???????????Gn?????????[J].CochraneDatabaseSystRev,2017,5:CD006109.[9]XuL,DingL,JiangJ,??????????????,????,???esinwomenfollowingaGnRH???????,Gn????????????agonistprotocol[J/OL].ReprodBiomedOnline,2019,39:???????,HCG????????????924‐930.????;?????б,???????????[10]???,??,??,?.?????????[J].???х???????、???????????????,2015,35:71‐79.[11]ESHREGuidelineGrouponOvarianStimulation,***E,?????????,????????????BroerS,:ovarianstimulationfor?Ч???Ч?????。????,?????IVF/ICSI[J].HumanReprodOpen,2020,2:1‐13.??????????????。[12]ZhangS,TangY,WangX,【????】oocyteretrievalinpatientswithlowovarianresponse:arandomizedcontrolledtrial[J].HumReprod,2022,37:[1]FerrarettiAP,LaMarcaA,FauserBC,‐‘poorresponse’toovarian[13]??,???,??.???????????????σ?stimulationforinvitrofertilization:theBolognacriteria[J].?????[J].??????,2013,22:806‐,2011,26:1616‐1624.[14]PolyzosNP,‐optimalrespondersfollowing[2]PoseidonGroup(Patient‐passingcontrolledovarianstimulation:anoverlookedgroup?[J].IndividualizeDOocyteNumber),AlviggiC,AndersenCY,HumReprod,2015,30:2005‐[15]???,???,???,?.?????????????ovarianstimulation:fromapoorovarianresponsetoalow????????????[J].??????,2020,29:prognosisconcept[J].FertilSteril,2016,105:1452‐‐580.[3]???,???,??,?.????σ????????σ[16]SefriouiO,MadkourA,KaarouchI,???????????1??????б?[J].????pretreatmentofpoorandnormalrespondersduringGnRH??,2020,29:1137‐[J].GynecolEndocrinol,2019,35:[4]??,???,???,?.????σ?????????1067‐??????2?POR??IVF‐ET???б?[J].?[17]MiyoshiT,OtsukaF,‐6mediatesFSH?????,2020,29:300‐[5]EstevesSC,AlviggiC,HumaidanP,[J].mun,2013,essthroughtheeyesofclinicians434:401‐[J].FrontEndocrinol(Lausanne),2019,[18]ChangEM,HanJE,WonHJ,:[6]ShahrokhTehraniNejadE,BakhtiariGhalehF,EslamiB,respondersinin‐vitrofertilization[J].,parisonofpre‐treatmentwithOCPsorestradiol2012,29:225‐‐treatmentpriortoGnRHantagonistused[19]ReynoldsKA,OmurtagKR,JimenezPT,:AnRCT[J].IntJReprodBiomed,2018,16:cancellationandpregnancyafterlutealestradiolprimingin535‐:asystematicreviewand[7]Montoya‐BoteroP,MartinezF,?????????‐PurataJ,‐analysis[J].HumReprod,2013,28:2981‐[20]BlockeelC,EngelsS,DeVosM,‐antagonistcycles:arandomizedcycles[J].HumReprod,2020,35:826‐[J/OL].ReprodBiomedOnline,2012,24:272‐280.[8]FarquharC,RombautsL,KremerJA,,progestogenoroestrogenpretreatmentforovarianstimulation[щ?:??]