促黄体激素在女性不孕症治疗中的作用:法国德尔菲共识。

IF 2.7 3区 医学 Q2 GENETICS & HEREDITY
Isabelle Cédrin-Durnerin, Julie Labrosse, Claire Castello Bridoux, Valérie de Buyst, Ségolène Paillet, Muriel Lubrano, Théo Cerceau, Stéphane Bouée, Bruno Salle, François Olivennes, Laetitia Jacquesson
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引用次数: 0

摘要

目的:阐明临床实践中对黄体生成素(LH)-促卵泡激素联合治疗的要求,并确定可能受益于黄体生成素-促卵泡激素联合治疗的患者概况。方法:德尔菲调查,科学顾问委员会阐述了28语句的作用促黄体激素(LH) folliculogenesis (n = 7语句),LH的效用卵泡排卵诱导/宫腔内人工受精前开发协议(n = 3),卵泡发展的效用LH受体激动剂或拮抗剂预处理协议之前试管婴儿(n = 6),活动促黄体激素的来源和类型(n = 3),和病人资料(n = 9)。这些陈述经两名试点专家审查和澄清。由26名法国艺术专家组成的评审团经过两轮投票。完全一致和一致分别定义为100%和> 66%的同意。在两轮投票之间可以重新拟订发言。结果:28个陈述中有24个完全一致或达成一致。所有关于黄体生成素在卵泡发生中的病理生理作用的论述都取得了共识。专家们赞同基础科学,并强调在临床中需要考虑个体间的差异。重组人黄体生成素被认为可以优化一系列患者的预后:对IVF刺激的次优卵巢反应、长期激动剂方案后的脱敏、高龄产妇(35岁以下)、多态性、低体重指数和促性腺功能低下的妇女。结论:来自法国专家代表小组的德尔菲共识提供了LH在卵泡发生中的关键重要性以及LH有益的患者概况的实际指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of luteinizing hormone in the management of female infertility: A French Delphi consensus.

Purpose: To clarify clinical practice with regard to LH requirements and identify patient profiles that could benefit from luteinizing hormone (LH)-follicle-stimulating hormone co-treatment.

Methods: In a Delphi survey, a scientific advisory board elaborated 28 statements on the role of luteinizing hormone (LH) in folliculogenesis (n = 7 statements), the utility of LH for follicular development prior to ovulation induction/intrauterine insemination protocols (n = 3), the utility of LH for follicular development prior to agonist or pretreated antagonist protocols in IVF (n = 6), the source and type of LH activity (n = 3), and patient profiles (n = 9). These statements were reviewed and clarified by two pilot experts. A panel of 26 French ART experts voted in two rounds. Full consensus and consensus were defined respectively as 100% and > 66% agreement. Statements could be reformulated between the two rounds of voting.

Results: A full consensus or a consensus was reached for 24 of the 28 statements. All the statements concerning the pathophysiological role of LH in folliculogenesis achieved a consensus. The experts endorsed the basic science and emphasized the need to consider inter-individual variability in the clinic. Recombinant human LH was considered to optimize outcomes in a range of patient profiles: a suboptimal ovarian response to IVF stimulation, desensitization following a long agonist protocol, advanced maternal age (> 35), polymorphisms, low body mass index, and women with hypogonadotropic hypogonadism.

Conclusions: This Delphi consensus from a representative group of French experts provided real-world guidance on LH's crucial importance in folliculogenesis and the patient profiles for which LH is beneficial.

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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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