子宫内膜异位症合并不孕患者的控制性卵巢刺激方案研究进展

doi:10.12280/gjszjk.20230158

摘要/Abstract

摘要：

体外受精-胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）是子宫内膜异位症（endometriosis，EMs）合并不孕的有效助孕方法，促性腺激素释放激素激动剂（gonadotropin-releasing hormone agonist，GnRHa）超长方案进行长期降调节有助于改善EMs合并不孕患者的妊娠结局。近年来，越来越多的促排卵方案被应用于EMs合并不孕患者，如拮抗剂方案和高孕激素状态下促排卵方案等。这些方案展现了改善EMs合并不孕患者妊娠结局的潜力，但因EMs病因不明、分期复杂和临床的异质性，EMs合并不孕患者促排卵方案的选择尚存在争议，需要更多高质量的临床研究来验证不同个体的促排卵方案的有效性。

关键词: 子宫内膜异位症, 控制性促排卵, 排卵诱导, 体外受精, 胚胎移植, 促性腺素释放激素, GnRH激动剂长方案, GnRH拮抗剂方案, 高孕激素状态下促排卵方案, 妊娠结局

Abstract:

In vitro fertilization-embryo transfer (IVF-ET) is an effective method for the treatment of infertility combined with endometriosis (EMs). The ultra-long protocol of gonadotropin-releasing hormone agonist (GnRHa) for the long-term down-regulation of pituitary can help to improve pregnancy outcomes in infertile patients with EMs. In recent years, more and more ovulation induction protocols have been applied in patients with EMs-related infertility, such as gonadotropin-releasing hormone antagonist (GnRH_A) protocol and progestin-primed ovarian stimulation (PPOS) protocol. These protocols have showed their potential in improving the pregnancy outcomes in patients with EMs-related infertility. However, the choice of ovulation induction protocols in patients with EMs-related infertility is controversial due to unknown etiology, complex staging and clinical heterogeneity. It is necessary to conduct more high-quality clinical studies to validate the efficiency of these protocols in the different individuals.

Key words: Endometriosis, Controlled ovarian stimulation, Ovulation induction, Fertilization in vitro, Embryo transfer, Gonadotropin-releasing hormone, GnRH-agonist long protocol, GnRH-antagonist protocol, Progestin-primed ovarian stimulation protocol, Pregnancy outcome

陈寅, 王菁, 冒韵东. 子宫内膜异位症合并不孕患者的控制性卵巢刺激方案研究进展[J]. 国际生殖健康/计划生育杂志, 2023, 42(5): 398-402.

CHEN Yin, WANG Jing, MAO Yun-dong. Research Progress of the Controlled Ovarian Stimulation Protocols for Women with Endometriosis-Related Infertility[J]. Journal of International Reproductive Health/Family Planning, 2023, 42(5): 398-402.

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