波塞冬组4卵巢低反应患者促排卵策略研究进展  

Research progress of ovarian stimulation strategy in patients with Poseidon group 4

作　　者：陈巧云 张野 陈璐[1] 刘建荣[2] CHEN Qiao-yun;ZHANG Ye;CHEN Lu;LIU Jian-rong(The Fifth Clinical College of Shanxi Medical University,Taiyuan 030000;Department of Reproductive Medicine,Shanxi Provincial People’s Hospital,Taiyuan030000)

机构地区：[1]山西医科大学第五临床医学院,太原030000 [2]山西省人民医院生殖医学科,太原030000

出　　处：《生殖医学杂志》2024年第9期1268-1273,共6页Journal of Reproductive Medicine

基　　金：中央引导地方科技发展项目(YDZJSX2022A069)。

摘　　要：随着晚婚晚育人群的逐年增加,高龄孕妇占比亦随之增加。高龄妇女卵巢储备功能降低,往往需要借助辅助生殖技术来助孕。卵巢低反应(POR)指的是在控制性促排卵过程中卵巢对促性腺激素反应差,且周期结局差。2016年基于博洛尼亚标准提出的波塞冬标准对POR患者进行了分层个体化管理,在一定程度上利于改善POR患者的妊娠结局。其中年龄≥35岁且卵巢储备功能低下[基础窦卵泡数(AFC)<5个,抗苗勒管激素(AMH)<1.2 ng/ml]的波塞冬组4 POR患者管理始终是辅助生殖技术中面临的主要难题之一。目前应用于波塞冬组4 POR患者的促排卵方案有微刺激/温和刺激方案、黄体期促排卵方案、重组黄体生成素+拮抗剂方案、高孕激素促排卵方案等,本文主要对波塞冬组4卵巢低反应患者的促排卵策略以及辅助治疗的研究进展进行综述。With the increase of late marriage and late childbearing year by year,the proportion of elderly pregnant women has increased.The ovarian reserve function of elderly pregnant women has decreased,and more and more pregnant women need reproductive technology for pregnancy.Poor ovarian response(POR)was mainly characterized by poor response to gonadotropin during controlled ovarian hyperovulation and poor cycle outcome.The Poseidon standard based on the Bologna standard proposed in 2016 provides hierarchical and individualized management of POR patients,which benefits for improving the pregnancy outcome of patients to a certain extent.The management of POR in the Poseidon group 4[≥35 years old and low ovarian reserve function(AFC<5,AMH<1.2 ng/ml)]is always a problem to face in the improvement of assisted reproductive technology.Combined with the latest studies in recent years,the ovarian stimulation protocol currently applied to POR in the Poseidon group 4 includes micro-stimulation/mild-stimulation,luteal phase ovarian stimulation,rLH+GnRH antagonist,and progestin-primed ovarian stimulation,etc.This article mainly introduces the research progress of ovarian stimulation strategies and auxiliary therapies in the Poseidon group 4 of POR women.

关 键 词：卵巢低反应 波塞冬组4 高孕激素促排卵 黄体期促排卵 微刺激/温和刺激 辅酶Q10 

分 类 号：R711.6[医药卫生—妇产科学]