非降调节FET是否优于降调节FET?
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摘要
冻融胚胎移植周期内膜准备方案可按照是否GnRH-a预处理分为非降调节和降调节FET方案,目前最为广泛应用的是非降调节方案,而降调节FET方案的适用人群仍在探索阶段,缺乏高质量临床研究支持。各种内膜准备方案都存在优缺点及适应人群,目前仍无证据支持存在最优的FET内膜准备方案。本文就冻融周期各种内膜准备方案的优缺点及降调节方案的可能适用人群作一综述。
Endometrium preparation protocols can be divided into non down-regulation and GnRH agonist down-regulation FET protocol.The non down-regulation protocol is most widely used.What kind patients are suitable for the down-regulated FET protocol is still being explored and lacks high-quality clinical research.Various endometrial preparation protocols have advantages and disadvantages and different suitable patients.There is still no evidence to support the existence of an optimal FET endometrium preparation protocol.This paper reviews the advantages and disadvantages of various protocols and the possible target population of GnRH agonist FET protocol.
Endometrium preparation protocols can be divided into non down-regulation and GnRH agonist down-regulation FET protocol.The non down-regulation protocol is most widely used.What kind patients are suitable for the down-regulated FET protocol is still being explored and lacks high-quality clinical research.Various endometrial preparation protocols have advantages and disadvantages and different suitable patients.There is still no evidence to support the existence of an optimal FET endometrium preparation protocol.This paper reviews the advantages and disadvantages of various protocols and the possible target population of GnRH agonist FET protocol.
引文
[1]Braga DP,Setti AS,Figueira RC,et al.Freeze-all,oocyte vitrification,or fresh embryo transfer?Lessons from an eggsharing donation program[J].Fertil Steril,2016,106:615-622.
[2]Chen ZJ,Shi Y,Sun Y,et al.Fresh versus frozen embryos for infertility in the polycystic ovary syndrome[J].N Engl J Med,2016,375:523-533.
[3]Gomaa H,Baydoun R,Sachak S,et al.Elective single embryo transfer:Is frozen better than fresh?[J].JBRA Assist Reprod,2016,20:3-7.
[4]Wong KM,Mastenbroek S,Repping S.Cryopreservation of human embryos and its contribution to in vitro fertilization success rates[J].Fertil Steril,2014,102:19-26.
[5]Peeraer K,Debrock S,Laenen A,et al.The impact of legally restricted embryo transfer and reimbursement policy on cumulative delivery rate after treatment with assisted reproduction technology[J].Hum Reprod,2014,29:267-275.
[6]Brosens JJ,Salker MS,Teklenburg G,et al.Uterine selection of human embryos at implantation[J].Sci Rep,2014,4:3894.
[7]Simon A,Hurwitz A,Zentner BS,et al.Transfer of frozenthawed embryos in artificially prepared cycles with and without prior gonadotrophin-releasing hormone agonist suppression:a prospective randomized study[J].Hum Reprod,1998,13:2712-2717.
[8]Younis JS,Simon A,Laufer N.Endometrial preparation:lessons from oocyte donation[J].Fertil Steril,1996,66:873-884.
[9]韩笑,陈圆辉,张少娣,等.GnRH-a降调节方案用于冻融胚胎移植内膜准备的适宜人群[J].生殖医学杂志,2016,25:915-918.
[10]Mackens S,Santos-Ribeiro S,van de Vijver A,et al.Frozen embryo transfer:a review on the optimal endometrial preparation and timing[J].Hum Reprod,2017,32:2234-2242.
[11]Byrd W.Cryopreservation,thawing,and transfer of human embryos[J].Semin Reprod Med,2002,20:37-43.
[12]Sathanandan M,Macnamee MC,Rainsbury P,et al.Replacement of frozen-thawed embryos in artificial and natural cycles:A prospective semi-randomized study[J].Hum Reprod,1991,6:685-687.
[13]Altmae S,Tamm-Rosenstein K,Esteban FJ,et al.Endometrial transcriptome analysis indicates superiority of natural over artificial cycles in recurrent implantation failure patients undergoing frozen embryo transfer[J/OL].Reprod Biomed Online,2016,32:597-613.
[14]Weissman A,Levin D,Ravhon A,et al.What is the preferred method for timing natural cycle frozen-thawed embryo transfer?[J/OL].Reprod Biomed Online,2009,19:66-71.
[15]Weissman A,Horowitz E,Ravhon A,et al.Spontaneous ovulation versus HCG triggering for timing natural-cycle frozen-thawed embryo transfer:a randomized study[J/OL].Reprod Biomed Online,2011,23:484-489.
[16]Hancke K,More S,Kreienberg R,et al.Patients undergoing frozen-thawed embryo transfer have similar live birth rates in spontaneous and artificial cycles[J].J Assist Reprod Genet,2012,29:403-407.
[17]Cobo A,de los Santos MJ,CastellòD,et al.Outcomes of vitrified early cleavage-stage and blastocyst-stage embryos in a cryopreservation program:evaluation of 3,150 warming cycles[J].Fertil Steril,2012,98:1138-1146.
[18]van de Vijver A,Polyzos NP,Van Landuyt L,et al.Cryopreserved embryo transfer in an artificial cycle:is GnRH agonist down-regulation necessary?[J/OL].Reprod Biomed Online,2014,29:588-594.
[19]Dal Prato L,Borini A,Cattoli M,et al.Endometrial preparation for frozen-thawed embryo transfer with or without pretreatment with gonadotropin-releasing hormone agonist[J].Fertil Steril,2002,77:956-960.
[20]Tomas C,Alsbjerg B,Martikainen H,et al.Pregnancy loss after frozen-embryo transfer--a comparison of three protocols[J].Fertil Steril,2012,98:1165-1169.
[21]Li SJ,Zhang YJ,Chai XS,et al.Letrozole ovulation induction:an effective option in endometrial preparation for frozen-thawed embryo transfer[J].Arch Gynecol Obstet,2014,289:687-693.
[22]Yarali H,Polat M,Mumusoglu S,et al.Preparation of endometrium for frozen embryo replacement cycles:a systematic review and meta-analysis[J].J Assist Reprod Genet,2016,33:1287-1304.
[23]Devroey P,Braeckmans P,Camus M,et al.Pregnancies after replacement of fresh and frozen-thawed embryos in a donation program[J].F Aspec Hum In Vitro Fertil,1987,133-137.
[24]Mathyk B,Adams N,Young SL.Endometrial receptivity:lessons from systems biology and candidate gene studies of endometriosis[J].Minerva Ginecol,2017,69:41-56.
[25]Dunselman GA,Vermeulen N,Becker C,et al.ESHRE guideline:management of women with endometriosis[J].Hum Reprod,2014,29:400-412.
[26]Mohamed AM,Chouliaras S,Jones CJ,et al.Live birth rate in fresh and frozen embryo transfer cycles in women with endometriosis[J].Eur J Obstet Gynecol Reprod Biol,2011,156:177-180.
[27]Niu Z,Chen Q,Sun Y,et al.Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis[J].Gynecol Endocrinol,2013,29:1026-1030.
[28]Tsai HW,Wang PH,Lin LT,et al.Using gonadotropinreleasing hormone agonist before frozen embryo transfer may improve ongoing pregnancy rates in hyperandrogenic polycystic ovary syndrome women[J].Gynecol Endocrinol,2017,33:686-689.
[29]江成龙,张昌军.降调节后雌孕激素替代内膜准备方案对改善PCOS患者FET结局的临床研究[J].中国计划生育学杂志,2015,23:455-457.
[30]解迪,陈枝岚,周蓉,等.多囊卵巢综合征患者降调节后冻融胚胎移植周期的临床结局观察[J].生殖医学杂志,2014,23:714-718.
[31]Yang X,Huang R,Wang YF,et al.Pituitary suppression before frozen embryo transfer is beneficial for patients suffering from idiopathic repeated implantation failure[J].J Huazhong Univ Sci Technolog Med Sci,2016,36:127-131.
[32]吴洪波,李柳铭,李慕军,等.GnRHa在冻融周期胚胎反复种植失败患者中的应用[J].国际生殖健康/计划生育杂志,2016,35:269-272.
[33]Hill MJ,Miller KA,Frattarelli JL.A GnRH agonist and exogenous hormone stimulation protocol has a higher livebirth rate than a natural endogenous hormone protocol for frozen-thawed blastocyst-stage embryo transfer cycles:an analysis of 1391cycles[J].Fertil Steril,2010,93:416-422.
[34]Groenewoud ER,Cantineau AE,Kollen BJ,et al.What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles?A systematic review and metaanalysis[J].Hum Reprod Update,2013,19:458-470.
[35]Groenewoud ER,Cantineau AE,Kollen BJ,et al.What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles?A systematic review and metaanalysis[J].Hum Reprod Update,2017,23:255-261.
[2]Chen ZJ,Shi Y,Sun Y,et al.Fresh versus frozen embryos for infertility in the polycystic ovary syndrome[J].N Engl J Med,2016,375:523-533.
[3]Gomaa H,Baydoun R,Sachak S,et al.Elective single embryo transfer:Is frozen better than fresh?[J].JBRA Assist Reprod,2016,20:3-7.
[4]Wong KM,Mastenbroek S,Repping S.Cryopreservation of human embryos and its contribution to in vitro fertilization success rates[J].Fertil Steril,2014,102:19-26.
[5]Peeraer K,Debrock S,Laenen A,et al.The impact of legally restricted embryo transfer and reimbursement policy on cumulative delivery rate after treatment with assisted reproduction technology[J].Hum Reprod,2014,29:267-275.
[6]Brosens JJ,Salker MS,Teklenburg G,et al.Uterine selection of human embryos at implantation[J].Sci Rep,2014,4:3894.
[7]Simon A,Hurwitz A,Zentner BS,et al.Transfer of frozenthawed embryos in artificially prepared cycles with and without prior gonadotrophin-releasing hormone agonist suppression:a prospective randomized study[J].Hum Reprod,1998,13:2712-2717.
[8]Younis JS,Simon A,Laufer N.Endometrial preparation:lessons from oocyte donation[J].Fertil Steril,1996,66:873-884.
[9]韩笑,陈圆辉,张少娣,等.GnRH-a降调节方案用于冻融胚胎移植内膜准备的适宜人群[J].生殖医学杂志,2016,25:915-918.
[10]Mackens S,Santos-Ribeiro S,van de Vijver A,et al.Frozen embryo transfer:a review on the optimal endometrial preparation and timing[J].Hum Reprod,2017,32:2234-2242.
[11]Byrd W.Cryopreservation,thawing,and transfer of human embryos[J].Semin Reprod Med,2002,20:37-43.
[12]Sathanandan M,Macnamee MC,Rainsbury P,et al.Replacement of frozen-thawed embryos in artificial and natural cycles:A prospective semi-randomized study[J].Hum Reprod,1991,6:685-687.
[13]Altmae S,Tamm-Rosenstein K,Esteban FJ,et al.Endometrial transcriptome analysis indicates superiority of natural over artificial cycles in recurrent implantation failure patients undergoing frozen embryo transfer[J/OL].Reprod Biomed Online,2016,32:597-613.
[14]Weissman A,Levin D,Ravhon A,et al.What is the preferred method for timing natural cycle frozen-thawed embryo transfer?[J/OL].Reprod Biomed Online,2009,19:66-71.
[15]Weissman A,Horowitz E,Ravhon A,et al.Spontaneous ovulation versus HCG triggering for timing natural-cycle frozen-thawed embryo transfer:a randomized study[J/OL].Reprod Biomed Online,2011,23:484-489.
[16]Hancke K,More S,Kreienberg R,et al.Patients undergoing frozen-thawed embryo transfer have similar live birth rates in spontaneous and artificial cycles[J].J Assist Reprod Genet,2012,29:403-407.
[17]Cobo A,de los Santos MJ,CastellòD,et al.Outcomes of vitrified early cleavage-stage and blastocyst-stage embryos in a cryopreservation program:evaluation of 3,150 warming cycles[J].Fertil Steril,2012,98:1138-1146.
[18]van de Vijver A,Polyzos NP,Van Landuyt L,et al.Cryopreserved embryo transfer in an artificial cycle:is GnRH agonist down-regulation necessary?[J/OL].Reprod Biomed Online,2014,29:588-594.
[19]Dal Prato L,Borini A,Cattoli M,et al.Endometrial preparation for frozen-thawed embryo transfer with or without pretreatment with gonadotropin-releasing hormone agonist[J].Fertil Steril,2002,77:956-960.
[20]Tomas C,Alsbjerg B,Martikainen H,et al.Pregnancy loss after frozen-embryo transfer--a comparison of three protocols[J].Fertil Steril,2012,98:1165-1169.
[21]Li SJ,Zhang YJ,Chai XS,et al.Letrozole ovulation induction:an effective option in endometrial preparation for frozen-thawed embryo transfer[J].Arch Gynecol Obstet,2014,289:687-693.
[22]Yarali H,Polat M,Mumusoglu S,et al.Preparation of endometrium for frozen embryo replacement cycles:a systematic review and meta-analysis[J].J Assist Reprod Genet,2016,33:1287-1304.
[23]Devroey P,Braeckmans P,Camus M,et al.Pregnancies after replacement of fresh and frozen-thawed embryos in a donation program[J].F Aspec Hum In Vitro Fertil,1987,133-137.
[24]Mathyk B,Adams N,Young SL.Endometrial receptivity:lessons from systems biology and candidate gene studies of endometriosis[J].Minerva Ginecol,2017,69:41-56.
[25]Dunselman GA,Vermeulen N,Becker C,et al.ESHRE guideline:management of women with endometriosis[J].Hum Reprod,2014,29:400-412.
[26]Mohamed AM,Chouliaras S,Jones CJ,et al.Live birth rate in fresh and frozen embryo transfer cycles in women with endometriosis[J].Eur J Obstet Gynecol Reprod Biol,2011,156:177-180.
[27]Niu Z,Chen Q,Sun Y,et al.Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis[J].Gynecol Endocrinol,2013,29:1026-1030.
[28]Tsai HW,Wang PH,Lin LT,et al.Using gonadotropinreleasing hormone agonist before frozen embryo transfer may improve ongoing pregnancy rates in hyperandrogenic polycystic ovary syndrome women[J].Gynecol Endocrinol,2017,33:686-689.
[29]江成龙,张昌军.降调节后雌孕激素替代内膜准备方案对改善PCOS患者FET结局的临床研究[J].中国计划生育学杂志,2015,23:455-457.
[30]解迪,陈枝岚,周蓉,等.多囊卵巢综合征患者降调节后冻融胚胎移植周期的临床结局观察[J].生殖医学杂志,2014,23:714-718.
[31]Yang X,Huang R,Wang YF,et al.Pituitary suppression before frozen embryo transfer is beneficial for patients suffering from idiopathic repeated implantation failure[J].J Huazhong Univ Sci Technolog Med Sci,2016,36:127-131.
[32]吴洪波,李柳铭,李慕军,等.GnRHa在冻融周期胚胎反复种植失败患者中的应用[J].国际生殖健康/计划生育杂志,2016,35:269-272.
[33]Hill MJ,Miller KA,Frattarelli JL.A GnRH agonist and exogenous hormone stimulation protocol has a higher livebirth rate than a natural endogenous hormone protocol for frozen-thawed blastocyst-stage embryo transfer cycles:an analysis of 1391cycles[J].Fertil Steril,2010,93:416-422.
[34]Groenewoud ER,Cantineau AE,Kollen BJ,et al.What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles?A systematic review and metaanalysis[J].Hum Reprod Update,2013,19:458-470.
[35]Groenewoud ER,Cantineau AE,Kollen BJ,et al.What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles?A systematic review and metaanalysis[J].Hum Reprod Update,2017,23:255-261.