高龄卵巢低反应患者体外受精/卵胞浆内单精子注射治疗策略

Management strategy for older patients with low response in IVF/ICSI

随着年龄的增长及女性卵巢储备的降低,在临床辅助生殖技术(ART)助孕时对促排卵药物的反应也降低,这主要与随着年龄增长的卵母细胞质量急剧恶化、卵泡闭锁加速、卵巢内可募集的卵泡数减少及卵母细胞质量异常有关。低反应患者卵巢产卵数量下降,并不完全等同于卵巢储备下降,这类患者需经过特殊处理才能获得最适当的卵母细胞数量和质量。在生殖医学的临床工作中鉴别潜在的低反应者及对这类群体的评价及处理,并实施个体化的治疗方案对其ART的成败具有重要意义。本文就文献中对ART助孕中高龄低反应患者的评估和治疗策略进行综述。

Low response to ovulation stimulants accompany with aging and degrading of ovarian reserve, and fertility potential reduction were related to reduction of recruited ovarian follicles, follicular atresia acceleration and deterioration of oocyte quality. Low response of ovarian means diminishing number of mature oocytes, rather than reduction of ovarian reserve. The patients with low response need to be specially treated to obtained adequate oocytes. It is very important for patient in IVF/ICSI to evaluate, identify and treat low response and make individualized treatment protocol. This paper reviews the evaluation and treatment protocol for ovarian stimulation of older patients with low response.