GnRH-a降调节在IVF或ICSI中的应用
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摘要
GnRH-a运用于辅助生殖领域已有30余年的历史,因其大大提高了临床妊娠率并降低了周期取消率,得到了广泛的运用。然而不同剂量的GnRH-a对垂体的抑制程度各异。由于不孕患者的个体差异、卵巢功能及年龄跨度大,GnRH-a的使用剂量及方案的选择尚未统一。本文拟对GnRH-a降调节在IVF或ICSI中应用进行综述,以期对辅助生殖技术的个体化临床应用提供依据。
Gn RH-a has been used in the field of assisted reproduction for more than 30 years, and it has been widely used because it greatly improves the clinical pregnancy rate and reduces the cycle cancellation rate. However,the different dose of GnRH-a,the different effect of pituitary down-regulation.Due to individual differences,ovarian function and age in infertility patients,there is no standard of dose and selection for GnRH-a.This article intends to review the application of GnRH-a in IVF or ICSI,in order to provide a basis for individualized clinical application of assisted reproductive technology.
Gn RH-a has been used in the field of assisted reproduction for more than 30 years, and it has been widely used because it greatly improves the clinical pregnancy rate and reduces the cycle cancellation rate. However,the different dose of GnRH-a,the different effect of pituitary down-regulation.Due to individual differences,ovarian function and age in infertility patients,there is no standard of dose and selection for GnRH-a.This article intends to review the application of GnRH-a in IVF or ICSI,in order to provide a basis for individualized clinical application of assisted reproductive technology.
引文
[1]Lahlou N.Pharmacokinetics and pharmcodynamics of triptorelin[J].Annals du rologie(Paris),2005,39(Suppl3):78-84.
[2]何钻玉,杨冬梓.进一步认识垂体降调节[J].生殖医学杂志,2013,22(10):731-736.
[3]卢锦,朱艳.卵泡发育及其调节因素的研究进展[J].医学综述,2008(04):507-509.
[4]Chun SY,Eisenhauer KM,Minanmi S,et al.Hormonal regulation of apoptosis in early antral follicles:follicle-stimulating hormone as major survival factor[J].Endocrinology,1996,137(4):1447-1456.
[5]FlemingR,ChungCC,YatesRWS,etal.Purifiedurinaryfollicle stimulating hormone induces different hormone profiles compared with menotrophins,dependent upon the route of administration and endogenous luteinizing hormone activity[J]. Hum Reprod,1996,11(9):1854-1858.
[6]Yim SF,Lok IH,Cheng LP,et al.Dose finding study for the use of long acting gonadotrophin releasing hormone analoges prior to ovarian stimulation for IVF[J]. Hum Reprod,2001,16(3):492-494.
[7]Tesarik J,Mendoza C.Effects of exogenous LH administration during ovarian stimulation of pituitary down-regulated young oocyte donors on oocyte yield and developmental competence[J]. Hum Reprod,2002,17(12):3129-3137.
[8]叶虹.降调节与卵泡发育同步化[J].生殖医学杂志,2011,20(S1):8-11+43.
[9]Humaidan P,Bungum L,Bungum M,et al.Ovarian response and pregnancy outcome related to mid-follicular LH levels in women undergoing assisted reproduction with Gn RH agonist down-regulation andrecombinant FSH stimulation[J].Hum Reprod, 2002,17(8):2016-2021.
[10]黄睿,李婷婷.不同剂量促性腺激素释放激素激动剂长方案中黄体生成素水平变化及临床意义[J].生殖医学杂志,2013,22(10):736-738.
[11]李洁,周灿权,钟依平,等.不同小剂量促性腺激素释放激素激动剂在体外受精-胚胎移植中应用的比较[J].中华妇产科杂志,2006(04):269-270.
[12]李晓红,武学清,王嵩,等.减量促性腺激素释放激素激动剂在超促排卵中的应用[J].生殖医学杂志,2003(03):146-149.
[13]朱艳.不同剂量促性腺激素释放激素激动剂控制性超排卵的临床效果观察[J].临床和实验医学杂志,2017,16(15):1525-1528.
[14]王芸,陈军,魏本翠,等.不同剂量GnRH-a长方案降调节对体外受精-胚胎移植结局影响的比较[J].中国优生与遗传杂志,2018,26(07):105-107+125.
[15]谢言信,潘萍,林海燕,等.正常卵巢功能患者使用不同降调方案的临床研究[J].中山大学学报(医学版),2018,39(03):405-412.
[16]叶贵丹,谭晓珊,胡雪梅,等.超促排卵长方案中长效促性腺激素释放激素激动剂用量的探讨[J].中国妇幼保健,2008(19):2718-2720.
[17]周红,张波,冯贵雪,等小剂量长效GnRH-a黄体中期卵巢刺激方案的临床效果分析[J].中国计划生育学杂志,2010,18(05):298-301.
[18]焦雪丹.长方案IVF/ICSI中应用减量长效GnRH-a降调节的临床对照研究[A].中华医学会、中华医学会生殖医学分会(The Chinese Society of Reproductive Medicine).中华医学会第六次全国生殖医学学术会议专刊[C].中华医学会、中华医学会生殖医学分会(The Chinese Society of Reproductive Medicine):,2012:1.
[19]林佳,赵军招,王佩玉,等.超低剂量长效达菲林降调节对体外受精-胚胎移植结局的影响[J].温州医学院学报,2013,43(09):595-598+602.
[20]王芸,陈军,魏本翠,等.不同剂量GnRH-a长方案降调节对体外受精-胚胎移植结局影响的比较[J].中国优生与遗传杂志,2018,26(07):105-107+125.
[21]粟妤.不同剂量长效和短效达菲林对垂体降调节的作用及对体外受精—胚胎移植结局的影响[D].南昌大学,2010.
[22]宋天然,孙海翔,王玢.卵巢储备功能下降患者减量长效及短效长方案疗效的比较[J].南京医科大学学报(自然科学版),2016,36(09):1143-1146.
[23]单丹,赵军招,吕杰强,等.不同剂量曲普瑞林降调节方案用于体外受精-胚胎移植的临床效果[J].浙江医学,2017,39(15):1258-1260+1264.
[24]Ren J,Sha A,Han D,et al.Does prolonged pituitary down-regulation withgonadotropin-releasing hormoneag-onist improve the live-birth rate in vitro fertilization treatment?[J]. Fertil Steril,2014,102(1):75-81.
[25]roenewoud ER,Cantineau AE,Kollen BJ,et al.What the optimal means ofpreparingtheendometriuminfrozen-thawedembryotransfer cycles?Asystematicreviewandmeta-analysis[J].HumReprod Update,2017,23(2):255-261.
[26]Aerward AR,Adams GP,Pierson RA,Ovarian antral folliculogenesis during the human menstral cycle:a review[J].Hum Reprod Update,2014,18:73-91.
[27]龙惠东,邓伟芬,王凤.个体化剂量长方案降调节在IVF-ET中的应用[J].生殖医学杂志,2018,27(04):356-361.
[2]何钻玉,杨冬梓.进一步认识垂体降调节[J].生殖医学杂志,2013,22(10):731-736.
[3]卢锦,朱艳.卵泡发育及其调节因素的研究进展[J].医学综述,2008(04):507-509.
[4]Chun SY,Eisenhauer KM,Minanmi S,et al.Hormonal regulation of apoptosis in early antral follicles:follicle-stimulating hormone as major survival factor[J].Endocrinology,1996,137(4):1447-1456.
[5]FlemingR,ChungCC,YatesRWS,etal.Purifiedurinaryfollicle stimulating hormone induces different hormone profiles compared with menotrophins,dependent upon the route of administration and endogenous luteinizing hormone activity[J]. Hum Reprod,1996,11(9):1854-1858.
[6]Yim SF,Lok IH,Cheng LP,et al.Dose finding study for the use of long acting gonadotrophin releasing hormone analoges prior to ovarian stimulation for IVF[J]. Hum Reprod,2001,16(3):492-494.
[7]Tesarik J,Mendoza C.Effects of exogenous LH administration during ovarian stimulation of pituitary down-regulated young oocyte donors on oocyte yield and developmental competence[J]. Hum Reprod,2002,17(12):3129-3137.
[8]叶虹.降调节与卵泡发育同步化[J].生殖医学杂志,2011,20(S1):8-11+43.
[9]Humaidan P,Bungum L,Bungum M,et al.Ovarian response and pregnancy outcome related to mid-follicular LH levels in women undergoing assisted reproduction with Gn RH agonist down-regulation andrecombinant FSH stimulation[J].Hum Reprod, 2002,17(8):2016-2021.
[10]黄睿,李婷婷.不同剂量促性腺激素释放激素激动剂长方案中黄体生成素水平变化及临床意义[J].生殖医学杂志,2013,22(10):736-738.
[11]李洁,周灿权,钟依平,等.不同小剂量促性腺激素释放激素激动剂在体外受精-胚胎移植中应用的比较[J].中华妇产科杂志,2006(04):269-270.
[12]李晓红,武学清,王嵩,等.减量促性腺激素释放激素激动剂在超促排卵中的应用[J].生殖医学杂志,2003(03):146-149.
[13]朱艳.不同剂量促性腺激素释放激素激动剂控制性超排卵的临床效果观察[J].临床和实验医学杂志,2017,16(15):1525-1528.
[14]王芸,陈军,魏本翠,等.不同剂量GnRH-a长方案降调节对体外受精-胚胎移植结局影响的比较[J].中国优生与遗传杂志,2018,26(07):105-107+125.
[15]谢言信,潘萍,林海燕,等.正常卵巢功能患者使用不同降调方案的临床研究[J].中山大学学报(医学版),2018,39(03):405-412.
[16]叶贵丹,谭晓珊,胡雪梅,等.超促排卵长方案中长效促性腺激素释放激素激动剂用量的探讨[J].中国妇幼保健,2008(19):2718-2720.
[17]周红,张波,冯贵雪,等小剂量长效GnRH-a黄体中期卵巢刺激方案的临床效果分析[J].中国计划生育学杂志,2010,18(05):298-301.
[18]焦雪丹.长方案IVF/ICSI中应用减量长效GnRH-a降调节的临床对照研究[A].中华医学会、中华医学会生殖医学分会(The Chinese Society of Reproductive Medicine).中华医学会第六次全国生殖医学学术会议专刊[C].中华医学会、中华医学会生殖医学分会(The Chinese Society of Reproductive Medicine):,2012:1.
[19]林佳,赵军招,王佩玉,等.超低剂量长效达菲林降调节对体外受精-胚胎移植结局的影响[J].温州医学院学报,2013,43(09):595-598+602.
[20]王芸,陈军,魏本翠,等.不同剂量GnRH-a长方案降调节对体外受精-胚胎移植结局影响的比较[J].中国优生与遗传杂志,2018,26(07):105-107+125.
[21]粟妤.不同剂量长效和短效达菲林对垂体降调节的作用及对体外受精—胚胎移植结局的影响[D].南昌大学,2010.
[22]宋天然,孙海翔,王玢.卵巢储备功能下降患者减量长效及短效长方案疗效的比较[J].南京医科大学学报(自然科学版),2016,36(09):1143-1146.
[23]单丹,赵军招,吕杰强,等.不同剂量曲普瑞林降调节方案用于体外受精-胚胎移植的临床效果[J].浙江医学,2017,39(15):1258-1260+1264.
[24]Ren J,Sha A,Han D,et al.Does prolonged pituitary down-regulation withgonadotropin-releasing hormoneag-onist improve the live-birth rate in vitro fertilization treatment?[J]. Fertil Steril,2014,102(1):75-81.
[25]roenewoud ER,Cantineau AE,Kollen BJ,et al.What the optimal means ofpreparingtheendometriuminfrozen-thawedembryotransfer cycles?Asystematicreviewandmeta-analysis[J].HumReprod Update,2017,23(2):255-261.
[26]Aerward AR,Adams GP,Pierson RA,Ovarian antral folliculogenesis during the human menstral cycle:a review[J].Hum Reprod Update,2014,18:73-91.
[27]龙惠东,邓伟芬,王凤.个体化剂量长方案降调节在IVF-ET中的应用[J].生殖医学杂志,2018,27(04):356-361.