国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2015, Vol. 34 ›› Issue (6): 519-523.

• 综述 • 上一篇    

控制性超促排卵后卵巢低反应的诊断及治疗

张阳阳，徐阳   

  1. 100034 北京大学第一医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-11-15 发布日期:2015-11-15
  • 通讯作者: 徐阳

Poor Response in Controlled Ovarian Hyperstimulation: Diagnosis and Treatment

ZHANG Yang-yang，XU Yang   

  1. Department of Gynecology and Obstetrics，Peking University First Hospital，Beijing 100034，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-11-15 Online:2015-11-15
  • Contact: XU Yang

PDF (PC)

7591

摘要： 卵巢低反应（POR）是指在控制性超促排卵（COH）过程中卵巢对促性腺激素（Gn）反应过低甚至无反应，导致获卵数少、周期取消率高以及临床妊娠率降低的一种现象，其发生率达到9%～24%，给患者造成了巨大的经济及精神负担，是辅助生殖技术（ART）领域中最具有挑战性的难题之一。目前卵巢低反应诊断标准尚不统一，2011年ESHRE达成了对POR诊断的共识：①年龄≥40岁或存在其他引起POR的高危因素；②POR史（常规卵巢刺激方案获卵数≤3个）；③卵巢储备功能降低，如AFC＜5～7个或AMH＜0.5～1.1 ng/mL;至少符合以上三点中的两点即可诊断为POR。本文介绍卵巢低反应治疗的最新进展，如调整促排卵方案及增加促排卵药物的用量及使用时间；使用雄激素或口服避孕药作预处理；加用生长激素、阿司匹林等。

关键词: 排卵诱导, 超排卵, 生殖技术, 辅助, 排卵监测, 卵巢低反应

Abstract: Poor ovarian response（POR）, which means insensitive to gonadotrophin in the controlled ovarian hyperstimulation （ＣＯＨ）, can result in fewer retrieved oocytes, higher cycle cancel rate and reduced clinical pregnancy rate. About 9%-24% of women who received COH treatment could have POR, which is one of the most challenging tasks in reproductive medicine. Until now, there is not accordant diagnostic criteria of POR. In 2011, ESHRE （European Society of human Reproction and Embryology） reached the Bologna Criteria: ①Age over or equal to 40 years, or other high-risk factor; ②History of POR (the number of retrieved oocytes in routine COH was less than or equal to 3）; ③The lowered ovarian function, such as AFC＜5-7 or AMH＜0.5-1.1 ng/mL. POR can be diagnosed if there are two in above three criterions. In this paper, we also introduced the treatment progress of POR, such as the adjusting COH, the increasing dose of gonadotrophin in COH, the pretreatment with androgens and oral contraceptive pills, and the adding growth hormone and aspirin.

Key words: Ovulation Induction, Superovulation, Reproductive Techniques, Assisted, Ovulation Detectio, Poor ovarian response