Сучасний погляд на протоколи контрольованої стимуляції яєчників у жінок репродуктивного віку з різним оваріальним резервом
DOI:
https://doi.org/10.15574/HW.2020.155-156.11Ключові слова:
екстракорпоральне запліднення, контрольована стимуляція яєчників, оваріальний резерв, гонадотропіниАнотація
Репродуктологія – одна з галузей сучасної медичної науки, що найбільш динамічно розвивається. Її значення стає особливо важливим за умов змін останніх років у соціумі, головною з яких є відкладання парою планів щодо народження дитини на більш пізній порівняно з попередніми поколіннями вік. Окрім того, така важлива та мультифакторна проблема, як безплідний шлюб, спонукає науковців до пошуку різноманітних шляхів її вирішення, зважаючи на численні етіологічні чинники та різний вихідний репродуктивний потенціал кожного з членів пари.
Екстракорпоральне запліднення (ЕКЗ), або запліднення in vitro (ЗІВ), дозволяє комплексно вирішити наявну проблему, оскільки процедура передбачає відтворення під ретельним контролем репродуктолога основних моментів запліднення, «оминаючи» критичні точки, які найчастіше підпадають під вплив патологічних процесів в організмі чоловіка та жінки.
Одним з основних параметрів, який визначає перспективи використання даних допоміжних репродуктивних технологій та, власне, стратегію проведення циклів ЕКЗ, є величина оваріального резерву, що характеризує функціональну спроможність яєчника генерувати фолікул самостійно/у відповідь на екзогенний вплив. Протягом останніх десятиліть було запропоновано чимало методів для його оцінювання та для можливості передбачити так звану бідну, погану відповідь яєчників на стимуляцію. Це у першу чергу пов’язане з тим, що для пацієнток зі зниженим оваріальним резервом доцільним є використання адаптованих схем контрольованої стимуляції яєчників (КСЯ), які враховують основні патофізіологічні властивості фолікулогенезу у даної категорії жінок.
Численні дослідження демонструють різні результати щодо ефективності використання препаратів гонадотропних гормонів (гонадотропінів) різного походження у жінок з різним оваріальним резервом.
У статті узагальнені сучасні дані з питань контрольованої стимуляції яєчників з використанням препаратів гонадотропних гормонів різного походження, продемонстровані основні клінічні аспекти використання наявних маркерів зниженого оваріального резерву. Проаналізовано дані щодо ефективності використання гонадотропінів у пацієнток з різним оваріальним резервом та описані можливі заходи для підвищення ефективності циклів ЕКЗ у пацієнток зі зниженим оваріальним резервом.
Посилання
Arslan M, Bocca S, Mirkin S, Barroso G, Stadtmauer L, Oehninger S. 2005. Controlled ovarian hyperstimulation protocols for in vitro fertilization: two decades of experience after the birth of Elizabeth Carr. Fertility and Sterility 84(3):555-69. https://doi.org/10.1016/j.fertnstert.2005.02.053; PMid:16169382
Denisenko SV, Dariy AS, Kononenko MI, Zerova-Lyubimova TE. 2008. Genetika reproduktsii. K, Ferz-TA:650.
Kogan IYu, Gzgzyan AM, Lesik EA. 2018. Protokolyi stimulyatsii yaichnikov v tsiklah EKO: rukovodstvo dlya vrachey. M, GEOTAR-Media:160.
Pepling ME. 2012, Feb. Follicular assembly: mechanisms of action. Reproduction. 143(2):139-49. https://doi.org/10.1530/REP-11-0299; PMid:22065859
Khalaf Y, El-Toukhy T, Taylor A, Braude P. 2002. Increasing the gonadotrophin dose in the course of an in vitro fertilization cycle does not rectify an initial poor response. European Journal of Obstetrics & Gynecology and Reproductive Biology 103(2):146-9. https://doi.org/10.1016/S0301-2115(02)00036-2
Balasch J, Vidal E, Penarrubia J, Casamitjana R, Carmona F, Creus M et al. 2001. Suppression of LH during ovarian stimulation: analysing threshold values and effects on ovarian response and the outcome of assisted reproduction in down-regulated women stimulated with recombinant FSH. Human Reproduction 16(8):163-46. https://doi.org/10.1093/humrep/16.8.1636; PMid:11473955
Lunenfeld B, Bilger W, Longobardi S, Alam V, D'Hooghe T, Sunkara SK. 2019. The Development of Gonadotropins for Clinical Use in the Treatment of Infertility. Front Endocrinol (Lausanne). 10:429. https://doi.org/10.3389/fendo.2019.00429; PMid:31333582 PMCid:PMC6616070
Kim DJ, Seok SH, Baek MW, Lee HY, Juhn JH, Lee S, Yun M, Park JH. 2010, May 15. Highly expressed recombinant human follicle-stimulating hormone from Chinese hamster ovary cells grown in serum-free medium and its effect on induction of folliculogenesis and ovulation. Fertil Steril. 93(8):2652-60. https://doi.org/10.1016/j.fertnstert.2009.05.009; PMid:19535048
Berger E, Chabloz P, Quay N, Sann A, Walton S, Germond M, Birkhauser M. 1999. An open, randomized, group-comparative bi-centre study comparing recombinant FSH Follitropinum beta 150 IU and highly purified urinary FSH 225 IU as a fixed dose regimen in IVF/ICSI treatment. Human Reproduction. 14;suppl 1:61-62. https://doi.org/10.1093/humrep/14.Suppl_3.61-a
Beall SA, DeCherney A. 2012. History and challenges surrounding ovarian stimulation in the treatment of infertility. Fertil Steril. 97(4):785-801. https://doi.org/10.1016/j.fertnstert.2012.02.030; PMid:22463773 PMCid:PMC4199635
Youssef MA, Al-Inany HG, Aboulghar M, Mansour R, Abou-Setta AM. 2011, Apr 13. Recombinant versus urinary human chorionic gonadotrophin for final oocyte maturation triggering in IVF and ICSI cycles. Cochrane Database Syst Rev. (4):CD003719. https://doi.org/10.1002/14651858.CD003719.pub3
Amirova AA, Nazarenko TA, Kolesnichenko TV, Mishieva NG. 2011. Analiz vzaimosvyazi mezhdu kliniko-anamnesticheskimi, kliniko-laboratornymi dannymi, osobennostyami induktsii superovulyatsii i ishodami EKO i EKO/IKSI. Problemy reproduktsii 1:73-77.
Jirge PR. Poor ovarian reserve. J Hum Reprod Sci. 2016;9(2):63-69.
Nazarenko TA. 2008. Stimulyatsiya funktsii yaichnikov. M, MEDpress-inform:272.
Nazarenko TA, Krasnopolskaya KV. 2013. «Bednyiy otvet». Taktika vedeniya patsientok so snizhennoy reaktsiey na stimulyatsiyu gonadotropinami v programmah EKO. M, MEDpress-inform:80.
Kvashenko VP, Vustenko VV. 2014. Analiz suchasnykh pidkhodiv do otsinky ovarialnoho rezervu u sviti. Medyko-sotsialni problemy simi 19;1:104-108.
Maheshwari A, Gibreel A, Bhattacharya S, Johnson NP. 2009. Dynamic tests of ovarian reserve: a systematic review of diagnostic accuracy. Reproductive Biomedicine Online. 18;5:717-734. https://doi.org/10.1016/S1472-6483(10)60019-3
Kobayashi A, Behringer RR. 2003. Developmental genetics of the female reproductive tract in mammals. Nat Rev Genet 4:969-80. https://doi.org/10.1038/nrg1225; PMid:14631357
Moses MM, Behringer RR. 2019. A gene regulatory network for Müllerian duct regression. Environ Epigenet. 5(3):dvz017. https://doi.org/10.1093/eep/dvz017; PMid:31579527 PMCid:PMC6760261
Masse J, Watrin T, Laurent A, Deschamps S, Guerrier D, Pellerin I. 2009. The developing female genital tract: from genetics to epigenetics. Int J Dev Biol 53:411-24. https://doi.org/10.1387/ijdb.082680jm; PMid:19412895
de Carvalho BR, Rosa e Silva ACJS, Rosa e Silva JC et al. 2008. Ovarian reserve evaluation: state of the art. Journal of Assisted Reproduction and Genetics. 25:311-322. https://doi.org/10.1007/s10815-008-9241-2; PMid:18679790 PMCid:PMC2596675
Fanchin R, Taieb J, Lozano DH, Ducot B, Frydman R, Bouyer J. 2005, Apr. High reproducibility of serum anti-Mullerian hormone measurements suggests a multi-staged follicular secretion and strengthens its role in the assessment of ovarian follicular status. Hum Reprod. 20(4):923-7. https://doi.org/10.1093/humrep/deh688; PMid:15640257
Sills ES, Alper MM, Walsh APH. 2009. Ovarian reserve screening in infertility: Practical applications and theoretical directions for research. European Journal of Obstetrics and Gynecology and Reproductive Biology. 146:30-36. https://doi.org/10.1016/j.ejogrb.2009.05.008; PMid:19487066
Amanvermez R, Tosun M. 2016, Jan-Mar. An Update on Ovarian Aging and Ovarian Reserve Tests. Int J Fertil Steril. 9(4):411-5.
Fridén B, Sjöblom P, Menezes J. 2011, Oct. Using anti-Müllerian hormone to identify a good prognosis group in women of advanced reproductive age. Aust N Z J Obstet Gynaecol. 51(5):411-5. https://doi.org/10.1111/j.1479-828X.2011.01374.x; PMid:21988118
Buyuk E, Seifer DB, Younger J, Grazi RV, Lieman H. 2011, Jun. Random anti-Müllerian hormone (AMH) is a predictor of ovarian response in women with elevated baseline early follicular follicle-stimulating hormone levels. Fertil Steril. 95(7):2369-72. https://doi.org/10.1016/j.fertnstert.2011.03.071; PMid:21497340
Yates AP, Rustamov O, Roberts SA et al. 2011. Anti-Mullerian hormone-tailored stimulation protocols improve outcomes whilst reducing adverse effects and costs of IVF. Human Reproduction. 26:2353-2362. https://doi.org/10.1093/humrep/der182; PMid:21672928
Kwee J, Schats R, McDonnell J, Lambalk CB, Schoemaker J. 2004, Mar. Intercycle variability of ovarian reserve tests: results of a prospective randomized study. Hum Reprod. 19(3):590-5. https://doi.org/10.1093/humrep/deh119; PMid:14998957
Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. 2006, Nov-Dec. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 12(6):685-718. https://doi.org/10.1093/humupd/dml034; PMid:16891297
Saxena P, Nigam A. 2012. Testing ovarian reserve: an important measure of fertility. INJMS. 3(2):165-169. https://doi.org/10.7713/ijms.2012.0046
Frattarelli JL, Bergh PA, Drews MR, Sharara FI, Scott RT. 2000, Sep. Evaluation of basal estradiol levels in assisted reproductive technology cycles. Fertil Steril. 74(3):518-24. https://doi.org/10.1016/S0015-0282(00)00693-2
Seifer DB, Lambert-Messerlian G, Hogan JW, Gardiner AC, Blazar AS, Berk CA. 1997, Jan. Day 3 serum inhibin-B is predictive of assisted reproductive technologies outcome. Fertil Steril. 67(1):110-4. https://doi.org/10.1016/S0015-0282(97)81865-1
Wunder DM, Guibourdenche J, Birkhäuser MH, Bersinger NA. 2008, Dec. Anti-Müllerian hormone and inhibin B as predictors of pregnancy after treatment by in vitro fertilization/intracytoplasmic sperm injection. Fertil Steril. 90(6):2203-10. https://doi.org/10.1016/j.fertnstert.2007.10.078; PMid:18291376
Siddiqui QUA, Anjum S, Zahra F, Yousuf SM. 2019, Jul-Aug. Ovarian reserve parameters and response to controlled ovarian stimulation in infertile patients. Pak J Med Sci. 35(4):958-962. https://doi.org/10.12669/pjms.35.4.753
Haadsma ML, Bukman A, Groen H, Roeloffzen EM, Groenewoud ER, Heineman MJ, Hoek A. 2007, Jul. The number of small antral follicles (2-6 mm) determines the outcome of endocrine ovarian reserve tests in a subfertile population. Hum Reprod. 22(7):1925-31. https://doi.org/10.1093/humrep/dem081; PMid:17437960
Christianson MS, Shoham G, Tobler KJ et al. 2015. Measurement of antral follicle count in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey. J Assist Reprod Genet. 32(10):1435-1440. https://doi.org/10.1007/s10815-015-0555-6; PMid:26341095 PMCid:PMC4615916
Gibreel A, Maheshwari A, Bhattacharya S, Johnson NP. 2009, Jun. Ultrasound tests of ovarian reserve; a systematic review of accuracy in predicting fertility outcomes. Hum Fertil (Camb). 12(2):95-106. https://doi.org/10.1080/14647270902896256; PMid:19802960
Lass A, Brinsden P. 1999, May-Jun. The role of ovarian volume in reproductive medicine. Hum Reprod Update. 5(3):256-66. https://doi.org/10.1093/humupd/5.3.256; PMid:10438110
Hendriks DJ, Kwee J, Mol BW, te Velde ER, Broekmans FJ. 2007, Apr. Ultrasonography as a tool for the prediction of outcome in IVF patients: a comparative meta-analysis of ovarian volume and antral follicle count. Fertil Steril. 87(4):764-75. https://doi.org/10.1016/j.fertnstert.2006.11.006; PMid:17239869
Popovic-Todorovic B, Loft A, Lindhard A, Bangsboll S, Andersson AM, Andersen AN. 2003. A prospective study of predictive factors of ovarian response in 'standard' IVF/ICSI patients treated with recombinant FSH: a suggestion for a recombinant FSH dosage normogram. Hum Reprod. 18:781-787. https://doi.org/10.1093/humrep/deg181; PMid:12660271
Moon KY, Kim H, Lee JY, Lee JR, Jee BC, Suh CS et al. 2016. Nomogram to predict the number of oocytes retrieved in controlled ovarian stimulation. Clin Exp Reprod Med. 43:112-8. https://doi.org/10.5653/cerm.2016.43.2.112; PMid:27358830 PMCid:PMC4925866
Lee D, Han SJ, Kim SK, Jee BC. 2018, Dec. A retrospective analysis of the follicle-stimulating hormone starting dose in expected normal responders undergoing their first in vitro fertilization cycle: proposed dose versus empiric dose. Clin Exp Reprod Med. 45(4):183-188. https://doi.org/10.5653/cerm.2018.45.4.183; PMid:30538949 PMCid:PMC6277670
Esteves SC, Roque M, Bedoschi GM, Conforti A, Humaidan P, Alviggi C. 2018. Defining Low Prognosis Patients Undergoing Assisted Reproductive Technology: POSEIDON Criteria-The Why. Front Endocrinol (Lausanne). 9:461. Published 2018, Aug 17. https://doi.org/10.3389/fendo.2018.00461; PMid:30174650 PMCid:PMC6107695
Ferraretti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L; ESHRE working group on Poor Ovarian Response Definition. 2011, Jul. ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 26(7):1616-24. https://doi.org/10.1093/humrep/der092; PMid:21505041
Leão Rde B, Esteves SC. 2014. Gonadotropin therapy in assisted reproduction: an evolutionary perspective from biologics to biotech. Clinics (Sao Paulo). 69(4):279-293. https://doi.org/10.6061/clinics/2014(04)10
Lunenfeld B. 2004, Nov-Dec. Historical perspectives in gonadotrophin therapy. Hum Reprod Update. 10(6):453-67. https://doi.org/10.1093/humupd/dmh044; PMid:15388674
Mennini FS, Marcellusi A, Viti R et al. 2018. Probabilistic cost-effectiveness analysis of controlled ovarian stimulation with recombinant FSH plus recombinant LH vs. human menopausal gonadotropin for women undergoing IVF. Reprod Biol Endocrinol. 16(1):68. Published 2018 Jul 18. https://doi.org/10.1186/s12958-018-0386-2; PMid:30021630 PMCid:PMC6052706
Al-Inany HG, Abou-Setta AM, Aboulghar MA, Mansour RT, Serour GI. 2008. Efficacy and safety of human menopausal gonadotrophins versus recombinant FSH: a meta-analysis. Reprod Biomed Online 16:81-88. https://doi.org/10.1016/S1472-6483(10)60559-7
Coomarasamy A, Afnan M, Cheema D, Veen F, Bossuyt PM, Wely M. 2008. Urinary HMG versus recombinant FSH for controlled ovarian hyperstimulation following an agonist long down-regulation protocol in IVF or ICSI treatment: a systematic review and meta-analysis. Hum Reprod 23:310-315. https://doi.org/10.1093/humrep/dem305; PMid:18056719
Daya S. 2002. Updated meta-analysis of recombinant follicle-stimulating hormone (FSH) versus urinary FSH for ovarian stimulation in assisted reproduction. Fertility and Sterility 77(4):711-4. https://doi.org/10.1016/S0015-0282(01)03246-0
Al-Inany H, Aboulghar M, Mansour R, Serour G. 2003, Feb. Meta-analysis of recombinant versus urinary-derived FSH: an update. Hum Reprod. 18(2):305-13. https://doi.org/10.1093/humrep/deg088; PMid:12571166
Al-Inany HG, Abou-Setta AM, Aboulghar MA, Mansour RT, Serour GI. 2008, Jan. Efficacy and safety of human menopausal gonadotrophins versus recombinant FSH: a meta-analysis. Reprod Biomed Online. 16(1):81-8. https://doi.org/10.1016/S1472-6483(10)60559-7
van Wely M, Kwan I, Burt AL et al. 2011. Recombinant versus urinary gonadotrophin for ovarian stimulation in assisted reproductive technology cycles. Cochrane Database Syst Rev. 2011(2):CD005354. Published 2011 Feb 16. https://doi.org/10.1002/14651858.CD005354.pub2; PMid:21328276 PMCid:PMC7388278
Hedon B, Out HJ, Hugues JN, Camier B, Cohen J, Lopes P et al. 1995. Efficacy and safety of recombinant follicle stimulating hormone (Puregon) in infertile women pituitary-suppressed with triptorelin undergoing in vitro fertilization: A prospective, randomized, assessor-blind, multicentre trial. Hum Reprod. 10:3102-6. https://doi.org/10.1093/oxfordjournals.humrep.a135866; PMid:8822422
Ng EH, Lau EY, Yeung WS, Ho PC. 2001. HMG is as good as recombinant human FSH in terms of oocyte and embryo quality: A prospective randomized trial. Hum Reprod. 16:319-25. https://doi.org/10.1093/humrep/16.2.319; PMid:11157827
Strehler E, Abt M, El-Danasouri I, De Santo M, Sterzik K. 2001. Impact of recombinant follicle-stimulating hormone and human menopausal gonadotropins on in vitro fertilization outcome. Fertil Steril. 75:332-6. https://doi.org/10.1016/S0015-0282(00)01696-4
Andersen AN, Devroey P, Arce JC for the MERIT group. 2006. Clinical outcome following stimulation with highly purified hMG or recombinant FSH in patients undergoing IVF: a randomized assessorblind controlled trial. Hum Reprod. 21:3217-27. https://doi.org/10.1093/humrep/del284; PMid:16873892
Selman HA, De Santo M, Sterzik K, Coccia E, El-Danasouri I. 2002. Effect of highly purified urinary follicle-stimulating hormone on oocyte and embryo quality. Fertil Steril. 78:1061-7. https://doi.org/10.1016/S0015-0282(02)04202-4
Balasch J, Peñarrubia J, Fábregues F, Vidal E, Casamitjana R, Manau D et al. 2003. Ovarian responses to recombinant FSH or HMG in normogonadotrophic women following pituitary desensitization by a depot GnRH agonist for assisted reproduction. Reprod Biomed Online. 7:35-42. https://doi.org/10.1016/S1472-6483(10)61726-9
Cheon KW, Byun HK, Yang KM, Song IО, Choi KH, Yoo KJ et al. 2004. Efficacy of recombinant human follicle-stimulating hormone in improving oocyte quality in assisted reproductive techniques. J Reprod Med. 49:733-8.
Kemeter P, Stroh-Weigert M, Feichtinger W. 2013. Ovarian stimulation with Urofollitropin (uFSH) results in a lower yield of oocytes compared to recombinant FSH (rFSH), nevertheless, uFSH is at least as effective as rFSH in younger patients: Preliminary results of a retrospective study with antagonist protocols in an IVF/ICSI Program. Open Reprod Sci J. 5:1-16. https://doi.org/10.2174/1874255620130812001
Ovarian Stimulation TEGGO, Bosch E, Broer S et al. 2020. ESHRE guideline: ovarian stimulation for IVF/ICSI†. Hum Reprod Open. 2020(2):hoaa009. Published 2020, May 1. https://doi.org/10.1093/hropen/hoaa009; PMid:32395637 PMCid:PMC7203749
Yu R, Jin H, Huang X, Lin J, Wang P. 2018. Comparison of modified agonist, mild-stimulation and antagonist protocols for in vitro fertilization in patients with diminished ovarian reserve. J Int Med Res. 46(6):2327-2337. https://doi.org/10.1177/0300060518770346; PMid:29695208 PMCid:PMC6023056
Xia X, Shi Y, Geng L, Liu D, Hou Z, Lin H, Li R, Wang H, Tao L, Meng F, Da J, Chen Y, Qiao J, Qian W, Li H. 2019, May. A cohort study of both human menopausal gonadotropin (HMG) and recombinant luteinizing hormone addition at early follicular stage in in vitro fertilization outcome: A STROBE-compliant study. Medicine (Baltimore). 98(19):e15512. https://doi.org/10.1097/MD.0000000000015512; PMid:31083194 PMCid:PMC6531138
Ferraretti AP, Gianaroli L, Magli MC, D'angelo A, Farfalli V, Montanaro N. 2004, Dec. Exogenous luteinizing hormone in controlled ovarian hyperstimulation for assisted reproduction techniques. Fertil Steril. 82(6):1521-6. https://doi.org/10.1016/j.fertnstert.2004.06.041; PMid:15589853
Meldrum DR, Scott RT Jr, Levy MJ, Alper MM, Noyes N. 2009, May. Oral contraceptive pretreatment in women undergoing controlled ovarian stimulation in ganirelix acetate cycles may, for a subset of patients, be associated with low serum luteinizing hormone levels, reduced ovarian response to gonadotropins, and early pregnancy loss. Fertil Steril. 91(5):1963-5. https://doi.org/10.1016/j.fertnstert.2008.01.007; PMid:18339377
Eskandar M, Jaroudi K, Jambi A, Archibong EI, Coskun S, Sobande AA. 2004, Jan. Is recombinant follicle-stimulating hormone more effective in IVF poor responders than human menopausal gonadotrophins? Med Sci Monit. 10(1):PI6-9.
Ji Z, Quan X, Lan Y, Zhao M, Tian X, Yang X. 2019. Gonadotropin versus Follicle-Stimulating Hormone for Ovarian Response in Patients Undergoing in vitro Fertilization: A Retrospective Cohort Comparison. Curr Ther Res Clin Exp. 92:100572. Published 2019 Dec 2. https://doi.org/10.1016/j.curtheres.2019.100572; PMid:31908689 PMCid:PMC6940711
Revelli A, Pettinau G, Basso G et al. 2015. Controlled Ovarian Stimulation with recombinant-FSH plus recombinant-LH vs. human Menopausal Gonadotropin based on the number of retrieved oocytes: results from a routine clinical practice in a real-life population. Reprod Biol Endocrinol. 13:77. Published 2015 Jul 25. https://doi.org/10.1186/s12958-015-0080-6; PMid:26209525 PMCid:PMC4514947
Lehert P, Kolibianakis EM, Venetis CA, Schertz J, Saunders H, Arriagada P, Copt S, Tarlatzis B. 2014, Feb 20. Recombinant human follicle-stimulating hormone (r-hFSH) plus recombinant luteinizing hormone versus r-hFSH alone for ovarian stimulation during assisted reproductive technology: systematic review and meta-analysis. Reprod Biol Endocrinol. 12:17. https://doi.org/10.1186/1477-7827-12-17; PMid:24555766 PMCid:PMC4015269
Wang Y, Li L, Deng K, Liu J, Liu Y, Zou K, Hao G, Sun X. 2020, Aug. Comparison of the combination of recombinant follicle-stimulating hormone and recombinant luteinizing hormone protocol versus human menopausal gonadotropin protocol in controlled ovarian stimulation: A systematic review and meta-analysis. J Evid Based Med. 13(3):215-226. https://doi.org/10.1111/jebm.12390; PMid:32627395
Ulug U, Ben-Shlomo I, Turan E, Erden HF, Akman MA, Bahceci M. 2003, Jun. Conception rates following assisted reproduction in poor responder patients: a retrospective study in 300 consecutive cycles. Reprod Biomed Online. 6(4):439-43. https://doi.org/10.1016/S1472-6483(10)62164-5
Pu D, Wu J, Liu J. 2011, Oct. Comparisons of GnRH antagonist versus GnRH agonist protocol in poor ovarian responders undergoing IVF. Hum Reprod. 26(10):2742-9. https://doi.org/10.1093/humrep/der240; PMid:21778283
Ubaldi F, Vaiarelli A, D'Anna R, Rienzi L. 2014. Management of poor responders in IVF: is there anything new? Biomed Res Int. 2014:352098. https://doi.org/10.1155/2014/352098; PMid:25136579 PMCid:PMC4127291
Polyzos NP, Blockeel C, Verpoest W, De Vos M, Stoop D, Vloeberghs V, Camus M, Devroey P, Tournaye H. 2012, Dec. Live birth rates following natural cycle IVF in women with poor ovarian response according to the Bologna criteria. Hum Reprod. 27(12):3481-6. https://doi.org/10.1093/humrep/des318; PMid:22940767
Ibrahim AE. 2014. The Minimal Stimulation Protocol for ICSI: An. Alternative Protocol for Ovarian Stimulation. N Y Sci J. 7:19-23.
Shrestha D, La X, Feng HL. 2015, Jun. Comparison of different stimulation protocols used in in vitro fertilization: a review. Ann Transl Med. 3(10):137.
Kar S. 2013, Apr. Current evidence supporting "letrozole" for ovulation induction. J Hum Reprod Sci. 6(2):93-8. https://doi.org/10.4103/0974-1208.117166; PMid:24082649 PMCid:PMC3778612
Bechtejew TN, Nadai MN, Nastri CO, Martins WP. 2017, Sep. Clomiphene citrate and letrozole to reduce follicle-stimulating hormone consumption during ovarian stimulation: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 50(3):315-323. https://doi.org/10.1002/uog.17442; PMid:28236310
Sobotka V, Streda R, Mardesic T, Tosner J, Heracek J. 2014, Jan. Steroids pretreatment in assisted reproduction cycles. J Steroid Biochem Mol Biol. 139:114-21. https://doi.org/10.1016/j.jsbmb.2013.04.007; PMid:23685395
Chang EM, Han JE, Won HJ, Kim YS, Yoon TK, Lee WS. 2012, Mar. Effect of estrogen priming through luteal phase and stimulation phase in poor responders in in-vitro fertilization. J Assist Reprod Genet. 29(3):225-30. https://doi.org/10.1007/s10815-011-9685-7; PMid:22160464 PMCid:PMC3288134
Escriva AM, Diaz-Garcia C, Monterde M, Rubio JM, Pellicer A. 2015, Jul. Antral Follicle Priming Before Intracytoplasmic Sperm Injection in Previously Diagnosed Low Responders: A Randomized Controlled Trial (FOLLPRIM). J Clin Endocrinol Metab. 100(7):2597-605. https://doi.org/10.1210/jc.2015-1194; PMid:25955224
Jeve YB, Bhandari HM. 2016, Apr-Jun. Effective treatment protocol for poor ovarian response: A systematic review and meta-analysis. J Hum Reprod Sci. 9(2):70-81. https://doi.org/10.4103/0974-1208.183515; PMid:27382230 PMCid:PMC4915289
##submission.downloads##
Опубліковано
Номер
Розділ
Ліцензія
Авторське право (c) 2020 Здоров’я жінки
Ця робота ліцензується відповідно до Creative Commons Attribution-NonCommercial 4.0 International License.
