常规卵泡期卵巢刺激与黄体期卵巢刺激：随机对照试验

FS Reports Pub Date : 2023-12-01 DOI:10.1016/j.xfre.2023.07.003

Jorge Suñol M.D. , Juan Carlos Castillo M.D., Ph.D. , José Antonio Ortiz M.Sc., Ph.D. , Jorge Ten M.Sc. Ph.D. , Ana Fuentes M.D. , Belén Moliner M.D., Ph.D. , María Martínez M.D. , Joaquín Llácer M.D., Ph.D. , Jaime Guerrero M.Sc. Ph.D. , Ana Pitas M.Sc. Ph.D. , Andrea Bernabeu M.D., Ph.D. , Rafael Bernabeu M.D., Ph.D.

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引用次数: 0

摘要

目的比较卵泡期促排卵（FPS）和黄体期促排卵（LPS）对次优反应者的卵母细胞产量。设计前瞻性、随机、交叉临床试验。受试者：41名不孕症患者，符合POSEIDON（以患者为导向的囊括个体化卵母细胞数的策略）标准（1b/2b）。体外受精周期不是连续的，而是在时间上分开的（45 天至 6 个月）。随机交叉设计确保了所有受试者都能在偶然情况下接受第一次治疗。主要结果测量指标的首要目标是每个周期中获得的积液-卵母细胞复合物数量。次要目标是分裂期 II 和受精卵细胞数、重组卵泡刺激素的额外剂量以及卵巢刺激持续时间（天数）。结果 FPS 组和 LPS 组获得的积液-卵母细胞复合体平均数量相似（7.5 ± 4.6 vs. 7.0 ± 4.1；95% 置信区间[CI]分别为 5.8-8.7 vs. 5.6-8.3；平均值之间的差异为-0.5；95% CI 为-1.8 至+1.5）。同样，FPS 组和 LPS 组取回的 II 期卵母细胞平均数量也没有差异（5.4 ± 3.6 vs. 5.2 ± 2.8；95% CI 分别为 4.2-6.5 vs. 4.3-6.1；平均值之间的差异为-0.2；95% CI 为-1.2 至+1.1）。此外，FPS组和LPS组的次要目标相似。结论：在本研究中，当LPS的开始时间与FPS的开始时间相隔较远时，与FPS相比，LPS的次优应答者的卵母细胞产量并没有增加。临床试验注册号NCT039393990 https://beta.clinicaltrials.gov/study/NCT03939390。

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Conventional follicular-phase ovarian stimulation vs. luteal-phase stimulation in suboptimal responders: a randomized controlled trial

Objective

To compare the oocyte yield between follicular-phase stimulation (FPS) and luteal-phase stimulation (LPS) in suboptimal responders.

Design

Prospective, randomized, crossover clinical trial.

Patient(s)

Forty-one patients with infertility according to the POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) criteria (1b/2b).

Intervention(s)

Crossover study on 2 assigned ovarian stimulations that started randomly in the follicular or luteal phase. The in vitro fertilization cycles were not consecutive but separated in time (45 days to 6 months). The random crossover design ensured that all subjects received the first treatment by chance.

Main Outcome Measure(s)

The primary objective was the number of cumulus-oocyte complexes retrieved in each cycle. Secondary objectives were number of metaphase II and fertilized oocytes, additional doses of recombinant follicle-stimulating hormone, and the duration of ovarian stimulation (days).

Result(s)

The mean number of cumulus-oocyte complexes retrieved was similar between the FPS and LPS groups (7.5 ± 4.6 vs. 7.0 ± 4.1; 95% confidence interval [CI] for the mean, 5.8–8.7 vs. 5.6–8.3, respectively; the difference between means, −0.5; 95% CI, −1.8 to +1.5). Similarly, the mean number of metaphase II oocytes retrieved was not different between the FPS and LPS groups (5.4 ± 3.6 vs. 5.2 ± 2.8; 95% CI for the mean, 4.2–6.5 vs. 4.3–6.1, respectively; the difference between means, −0.2; 95% CI, −1.2 to +1.1). Moreover, the secondary objectives were similar between FPS and LPS groups.

Conclusion(s)

In this study, the oocyte yield in LPS did not increase in suboptimal responders compared with that in FPS when the onset of LPS was separated in time from FPS.