降调节后促性腺激素的启动标准

Optimal gonadotrophin starting dose after down regulation in COS

体外受精-胚胎移植（IVF—ET）中控制性卵巢刺激（COS）使多个卵泡发育，从而获取多个卵母细胞和胚胎，提高妊娠率。COS方案常通过促性腺激素释放激素激动剂（GnRH—a）垂体降调节抑制垂体促性腺激素（Gn）的分泌，可以抑制内源性的LH峰，避免卵泡黄素化，促进多卵泡发育，降低周期取消率。卵巢对促排卵刺激的内分泌和卵泡反应是影响IVF成功的主要因素。降调节后卵巢对刺激的反应与降调节的程度、卵巢刺激药物剂量、卵巢储备和机体特异性相关。本文将就降调节后Gn启动的时机、剂量等进行综述。

The varying ovarian response to gonadotrophins may be due to factors such as age, basal FSH, number of antral follicle and body mass index, all of them should be taken into account before choosing the type of protocol and the amount of gonadotrophins used. The actual role of LH in controlled ovarian stimulation is still a matter of debate. CONSORT FSH predictive algorithm results are encouraging and deserve further investigation. Further research in pharmacogenomics will drive the possibility to stratified medicine in fertility treatment