2015年至2023年,13000多名卵巢应答不良者的累计活产率:一项评估自然周期和控制卵巢刺激疗效的回顾性队列研究

IF 2.7 3区 医学 Q2 GENETICS & HEREDITY
Jiaxin Lv, Wei Guo, Tian Tian, Lixue Chen, Xiumei Zhen, Rong Li, Jie Qiao, Rui Yang
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引用次数: 0

摘要

背景:自然周期体外受精(NC-IVF)是一种方便、安全的辅助生殖技术,尤其适用于卵巢反应差(POR)的患者。本研究评估NC-IVF对POR妇女的有效性,旨在为个性化治疗决策提供信息。方法:这项回顾性队列研究包括13013个周期,包括根据博洛尼亚标准诊断为卵巢反应不良的妇女。这些患者接受自然周期或控制卵巢刺激周期。主要结局指标是累计活产率,次要结局包括实验室和临床结局。结果:共分析自然周期1073例,COS周期11940例,其中低剂量促性腺激素治疗5956例,高剂量促性腺激素治疗5984例。三组患者基本特征具有可比性。在新鲜和冷冻胚胎移植周期中,三组的临床妊娠率、着床率和活产率具有可比性。此外,在累积活产率或首次活产时间方面,两组间没有统计学上的显著差异。自然周期组的支出明显低于两个COS组。重要的是,进一步的分析表明,在妊娠并发症或新生儿结局方面,三组之间没有显著差异。结论:我们的研究结果表明,对于卵巢反应较差的女性,与对照卵巢刺激方法相比,NC治疗的妊娠率和活产率相当。对于这类患者,自然周期是一种安全、有效、经济可行的治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cumulative live birth rates among over 13,000 poor ovarian responders from 2015 to 2023: a retrospective cohort study assessing the efficacy of natural cycle and controlled ovarian stimulation.

Background: Natural cycle in vitro fertilization (NC-IVF) represents a convenient and safe assisted reproductive technology, making it particularly advantageous for patients with poor ovarian response (POR). This research evaluates the effectiveness of NC-IVF for women with POR, aiming to inform personalized treatment decisions.

Method: This retrospective cohort study encompassed 13,013 cycles involving women diagnosed with poor ovarian response according to the Bologna criteria. These patients underwent either natural cycles or controlled ovarian stimulation cycles. The primary outcome measure was the cumulative live birth rates, and the secondary outcomes included laboratory and clinical outcomes.

Results: A total of 1073 natural cycles and 11,940 COS cycles were analyzed, with 5956 undergoing low-dose gonadotropin treatment and 5984 receiving high-dose gonadotropin. The basic characteristics were comparable among the three groups. In both fresh and frozen embryo transfer cycles, clinical pregnancy rates, implantation rates, and live birth rates were comparable across all three groups. Furthermore, no statistically significant differences were observed in cumulative live birth rates or time to first live birth between the groups examined. Expenditures in the natural cycle group were substantially lower than those in both COS cohorts. Importantly, further analysis indicated that there were no significant differences among the three groups concerning either pregnancy complications or neonatal outcomes.

Conclusion: Our findings indicate that for women demonstrating a poor ovarian response, NC treatment yields comparable pregnancy and live birth rates when compared to controlled ovarian stimulation methods. The natural cycle represents a safe, effective, and economically viable treatment option for this patient population.

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来源期刊
CiteScore
5.70
自引率
9.70%
发文量
286
审稿时长
1 months
期刊介绍: The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.
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