国际生殖健康/计划生育 ›› 2012, Vol. 31 ›› Issue (3): 228-230.

• 综述 • 上一篇    下一篇

微刺激促排卵方案的研究进展

王亦理,孙莹璞   

  1. 610041 四川大学华西第二医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-05-15 发布日期:2012-05-15

Research Progress of Mild IVF

WANG Yi-li,SUN Ying-pu   

  1. Reproductive Center of the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China
  • Received:1900-01-01 Revised:1900-01-01 Published:2012-05-15 Online:2012-05-15

摘要: 在辅助生殖技术应用中,常规促排卵方案因具有促进多卵泡发育、降低周期取消率并增加临床可控性等优势,成为促排卵方案中的主要方案,但是在其临床应用中可以观察到卵子胚胎的质量下降及子宫内膜容受性改变,而且促性腺激素(Gn)用量增加改变了体内激素环境,提高了并发症如卵巢过度刺激综合征(OHSS)及多胎妊娠等的发生率,进而影响患者的依从性。因此,如何选择一个安全、经济、高效的卵巢刺激方案,已成为临床辅助生殖技术应用中的首要问题。随着实验室操作技术及临床药物的发展,微刺激促排卵方案较常规长方案降低了Gn用量,模拟自然状态下卵子及胚胎的发生发育,操作简便,药物周期短,费用低廉并且显著降低了OHSS及多胎妊娠的发生率,改善了出生婴儿的结局,并获得了可观的妊娠率。现就微刺激促排卵方案在临床应用中的优劣因素进行分析。

关键词: 排卵诱导, 临床方案, 卵子, 胚泡, 卵巢过度刺激综合征, 先天畸形, 依从性

Abstract: Conventional IVF has been the main strategy as it facilitates the development of multiple follicles and reduce the cancel rate in ART applications. However, it was observed that conventional IVF had the change in oocyte quality, embryos quality and endometrial receptivity which had side effect on IVF outcome. Other problems of conventional IVF included OHSS, multiple pregnancies and high cost which affect patients' compliance. So the need for a large number of oocytes as an integral part of a successful IVF programme may be queried. And how to balance between safety and effectiveness is a difficult question of clinical ART. With the development of techniques and medicine, mild IVF lowered Gn dosage by simulating natural development of follicle and embryo. Mild IVF was characterized by easy and simple to handle, short duration of medical treatment, low cost, and low rates of OHSS and multiple pregnancies. Mild IVF with the acceptable pregnancy rate improved the clinical outcomes of babies. We reviewed the current knowledge about mild IVF, advantages and disadvantages of mild IVF in clinical practice.

Key words: Ovulation induction, Clinical protocols, Ovum, Blastocyst, Ovarian hyperstimulation syndrome, Congenital abnormalities