Research Progress of Trigger Scheme in Ovarian Hyperstimulation Cycles in Infertile Women with Polycystic Ovary Syndrome

doi:10.12280/gjszjk.20200529

Abstract

Abstract:

For infertile patients with polycystic ovary syndrome (PCOS), it is necessary to optimize the trigger scheme so as to obtain more well-matured oocytes, higher pregnancy rate and better cycle outcomes, and to reduce the incidence of ovarian hyperstimulation syndrome (OHSS) and empty follicle syndrome (empty follicle syndrome, EFS) risk. When making the trigger plan, we need to consider the drug preparation and timing of trigger. Human chorionic gonadotropin (hCG) trigger, gonadotropin-releasing hormone agonist (GnRHa) trigger, Kisspeptin trigger, dual trigger, double trigger and other trigger methods have been used in PCOS infertile patients. Based on the literature review of the ovarian hyperstimulation trigger schemes for PCOS infertile patients, the trigger drugs, dosage, advantages and disadvantages of different trigger schemes were compared in this paper, including the standard of trigger timing. These comparisons provide us a useful reference for the clinical development of PCOS personalized trigger scheme.

Key words: Polycystic ovary syndrome, Fertilization in vitro, Ovulation induction, Trigger, Ovarian hyperstimulation syndrome

QIN Yi-ming, KONG Xin-liang, ZHANG Jian-wei. Research Progress of Trigger Scheme in Ovarian Hyperstimulation Cycles in Infertile Women with Polycystic Ovary Syndrome[J]. Journal of International Reproductive Health/Family Planning, 2021, 40(3): 226-230.

Figures/Tables 1

References 28

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制剂	规格	常用剂量	优点	缺点
u-hCG	500 IU,1 000 IU,2 000 IU, 3 000 IU,5 000 IU	2 000~10 000 IU	应用时间长;费用低廉	刺激VEGF表达,增加OHSS发生风险
r-hCG	250 μg∶0.5 mL	250 μg	制备方便;出现注射部位不良反应的概率较u-hCG更低	刺激VEGF表达,增加OHSS发生风险
GnRHa	0.1 mg,3.75 mg,15 mg	0.2 mg	正向调节FSH、LH;减少VEGF分泌,降低OHSS发生风险	易导致黄体功能不足
Kisspeptin	50 μg	尚未确定	诱导内源性FSH和LH释放,降低OHSS发生风险	黄体期损害较GnRHa更大;相关研究不足

制剂	规格	常用剂量	优点	缺点
u-hCG	500 IU,1 000 IU,2 000 IU, 3 000 IU,5 000 IU	2 000~10 000 IU	应用时间长;费用低廉	刺激VEGF表达,增加OHSS发生风险
r-hCG	250 μg∶0.5 mL	250 μg	制备方便;出现注射部位不良反应的概率较u-hCG更低	刺激VEGF表达,增加OHSS发生风险
GnRHa	0.1 mg,3.75 mg,15 mg	0.2 mg	正向调节FSH、LH;减少VEGF分泌,降低OHSS发生风险	易导致黄体功能不足
Kisspeptin	50 μg	尚未确定	诱导内源性FSH和LH释放,降低OHSS发生风险	黄体期损害较GnRHa更大;相关研究不足