| 10,981 | 575 | 721 |
| 下载次数 | 被引频次 | 阅读次数 |
随着生育年龄的后延,卵巢储备功能减退(DOR)对生育的不良影响越加严重,目前国内外对DOR的诊断和治疗尚无统一的意见,改善DOR患者的生育措施也不完善。为使国内各级妇产科医师更好地认识、诊治和管理DOR女性,国内该领域的专家基于国内外循证证据,结合我国临床实践,综合考虑辅助生育措施的成本,编写了“卵巢储备功能减退临床诊治专家共识”,为临床实践中DOR的规范诊疗提供科学、恰当的指导。
Abstract:There is no generally-accepted criteria for the diagnosis and management of diminished ovarian reserve(DOR) yet, even though its influences on fertility deteriorate with the delay of marriage and childbearing, the methods of improving fertility in DOR patients are neither satisfied. For better management of DOR,Chinese experts in this field develop this expert consensus, based on the relevant Chinese and international guidelines and literature of the cost-effectiveness of methods to improve fertility of DOR patients, in order to improve understanding of DOR related health, infertility and standardize the procedures of management in DOR patients.
[1] Shan D,Qiu PY,Wu YX,et al.Pregnancy outcomes in women of advanced maternal age:a retrospective cohort study from China[J].Sci Rep,2018,8:12239.
[2] Pastore LM,Christianson MS,Stelling J,et al.Reproductive ovarian testing and the alphabet soup of diagnoses:DOR,POI,POF,POR,and FOR[J].J Assist Reprodu Genet,2018,35:17-23.
[3] Practice Committee of the American Society for Reproductive Medicine.Testing and interpreting measures of ovarian reserve:a committee opinion[J].Fertil Steril,2015,103:e9-e17.
[4] Dogan S,Cicek OSY,Demir M,et al.The effect of growth hormone adjuvant therapy on assisted reproductive technologies outcomes in patients with diminished ovarian reserve or poor ovarian response[J].J Gynecol Obstet Hum Reprod,2021,50:101982.
[5] Cohen J,Chabbert-Buffet N,Darai E.Diminished ovarian reserve,premature ovarian failure,poor ovarian responder-a plea for universal definitions[J].J Assist Reprod Genet,2015,32:1709-1712.
[6] Jiao Z,Bukulmez O.Potential roles of experimental reproductive technologies in infertile women with diminished ovarian reserve[J].J Assist Reprod Genet,2021,38:2507-2517.
[7] 中华医学会生殖医学分会.中国高龄不孕女性辅助生殖临床实践指南[J].中国循证医学杂志,2019,19:253-270.
[8] Yu R,Jin H,Huang X,et al.Comparison of modified agonist,mild-stimulation and antagonist protocols forin vitrofertilization in patients with diminished ovarian reserve[J].J int Med Res,2018,46:2327-2337.
[9] European Society for Human Reproduction and Embryology (ESHRE)Guideline Group on POI.ESHRE Guideline:management of women with premature ovarian insufficiency[J].Hum Reprod,2016,31:926-937.
[10] 陈子江,田秦杰,乔杰,等.早发性卵巢功能不全的临床诊疗中国专家共识[J].中华妇产科杂志,2017,52:577-681.
[11] Welt CK.Primary ovarian insufficiency:a more accurate term for premature ovarian failure[J].Clin Endocrinol,2008,68:499-509.
[12] 武学清,孔蕊,田莉,等.卵巢低反应专家共识[J].生殖与避孕,2015,35:71-79.
[13] Ferraretti AP,La Marca A,Fauser BC,et al.ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization:the Bologna criteria[J].Hum Reprod,2011,26:1616-1624.
[14] Humaidan P,Alviggi C,Fischer R,et al.The novel POSEIDON stratification of ‘Low prognosis patients in Assisted Reproductive Technology’ and its proposed marker of successful outcome[J].F1000Res,2016,5:2911.
[15] Haahr T,Dosouto C,Alviggi C,et al.Management strategies for POSEIDON Groups 3 and 4[J].Front Endocrinol (Lausanne),2019,10:614.
[16] Sun W,Stegmann BJ,Henne M,et al.A new approach to ovarian reserve testing[J].Fertil Steril,2008,90:2196-2202.
[17] Jiao X,Zhang X,Li N,et al.Treg deficiency-mediated TH1 response causes human premature ovarian insufficiency through apoptosis and steroidogenesis dysfunction of granulosa cells[J].Clin Transl Med,2021,11:e448.
[18] 中华医学会妇产科学分会绝经学组.中国绝经管理与绝经激素治疗指南(2018)[J].协和医学杂志,2018,9:512-525.
[19] 中华预防医学会妇女保健分会更年期保健学组.更年期妇女保健指南(2015年)[J].实用妇科内分泌杂志(电子版),2016,3:21-32.
[20] 中国医师协会全科医师分会,北京妇产学会社区与基层分会.更年期妇女健康管理专家共识(基层版)[J].中国全科医学,2021,24:1317-1323.
[21] Tal R,Seifer DB.Ovarian reserve testing:a user’s guide[J].Am J Obstet Gynecol,2017,217:129-140.
[22] Broer SL,Broekmans FJ,Laven JS,et al.Anti-Mullerian hormone:ovarian reserve testing and its potential clinical implications[J].Hum Reprod Update,2014,20:688-701.
[23] Zhang HH,Xu PY,Wu J,et al.Dehydroepiandrosterone improves follicular fluid bone morphogenetic protein-15 and accumulated embryo score of infertility patients with diminished ovarian reserve undergoing in vitro fertilization:a randomized controlled trial[J].J ovarian Res,2014,7:93.
[24] Smotrich DB,Widra EA,Gindoff PR,et al.Prognostic value of day 3 estradiol on in vitro fertilization outcome[J].Fertil Steril,1995,64:1136-1140.
[25] Committee opinion no.618:Ovarian reserve testing[J].Obstet Gynecol,2015,125:268-273.
[26] American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee.Female age-related fertility decline.Committee Opinion No.589[J].Fertil Steril,2014,101:633-634.
[27] Gaskins AJ,Rich-Edwards JW,Missmer SA,et al.Association of fecundity with changes in adult female weight[J].Obstet Gynecol,2015,126:850-858.
[28] Practice Committee of the American Society for Reproductive Medicine.Comparison of pregnancy rates for poor responders using IVF with mild ovarian stimulation versus conventional IVF:a guideline[J].Fertil Steril,2018,109:993-999.
[29] Bukulmez O.The International Society for Mild Approaches in Assisted Reproduction (ISMAAR)definitions for mild stimulation and their rationale for assisted reproductive technologies[A].in:in:Bukulmez O(ed).Diminished ovarian reserve and assisted reproductive technologies[M].Springer,2020:141-149.
[30] Shang W.Traditional Chinese Medicine for assisted reproductive technology[A].in:Bukulmez O(ed).Diminished ovarian reserve and assisted reproductive technologies[M].Springer,2020:75-104.
[31] Nargund G,Fauser B,Macklon N,et al.The ISMAAR proposal on terminology for ovarian stimulation for IVF[J].Hum Reprod,2007,22:2801-2804.
[32] Youssef M,Van Wely M,Al-Inany H,et al.A mild ovarian stimulation strategy in women with poor ovarian reserve undergoing IVF:a multicenter randomized non-inferiority trial[J].Hum Reprod,2017,32:112-118.
[33] Klinkert E,Broekmans F,Looman C,et al.Expected poor responders on the basis of an antral follicle count do not benefit from a higher starting dose of gonadotrophins in IVF treatment:a randomized controlled trial[J].Hum Reprod,2005,20:611-615.
[34] 黄存,孟艳,钱易,等.低剂量Gn联合克罗米芬刺激方案在IVF/ICSI中的应用[J].生殖医学杂志,2017,26:961-966.
[35] 张潇潇,吕群.探讨高龄体外受精患者温和刺激方案中生长激素预处理的疗效[J].检验医学与临床,2018,15:900-902.
[36] Chu K,Pang W,Sun N,et al.Outcomes of poor responders following growth hormone co-treatment with IVF/ICSI mild stimulation protocol:a retrospective cohort study[J].Arch Gynecol Obstet,2018,297:1317-1321.
[37] Drakopoulos P,Bardhi E,Boudry L,et al.Update on the management of poor ovarian response in IVF:the shift from Bologna criteria to the POSEIDON concept[J].Ther Adv Reprod Health,2020,14:2633494120941480.
[38] Sunkara SK,Coomarasamy A,Faris R,et al.Long gonadotropin-releasing hormone agonist versus short agonist versus antagonist regimens in poor responders undergoing in vitro fertilization:a randomized controlled trial[J].Fertil Steril,2014,101:147-153.
[39] Prapas Y,Petousis S,Dagklis T,et al.GnRH antagonist versus long GnRH agonist protocol in poor IVF responders:a randomized clinical trial[J].Eur J Obstet Gynecol Reprod Biol,2013,166:43-46.
[40] Pu D,Wu J,Liu J.Comparisons of GnRH antagonist versus GnRH agonist protocol in poor ovarian responders undergoing IVF[J].Hum Reprod,2011,26:2742-2749.
[41] Berkkanoglu M,Ozgur K.What is the optimum maximal gonadotropin dosage used in microdose flare-up cycles in poor responders?[J].Fertil Steril,2010,94:662-665.
[42] Baker VL,Brown MB,Luke B,et al.Gonadotropin dose is negatively correlated with live birth rate:analysis of more than 650,000 assisted reproductive technology cycles[J].Fertil Steril,2015,104:1145-1152.
[43] Alviggi C,Conforti A,Esteves SC,et al.Recombinant luteinizing hormone supplementation in assisted reproductive technology:a systematic review[J].Fertil Steril,2018,109:644-664.
[44] Vaiarelli A,Cimadomo D,Trabucco E,et al.Double stimulation in the same ovarian cycle (DuoStim)to maximize the number of oocytes retrieved from poor prognosis patients:a multicenter experience and SWOT analysis[J].Front Endocrinol (Lausanne),2018,9:317.
[45] Lainas TG,Sfontouris IA,Venetis CA,et al.Live birth rates after modified natural cycle compared with high-dose FSH stimulation using GnRH antagonists in poor responders[J].Hum Reprod,2015,30:2321-2330.
[46] Polyzos N,Blockeel C,Verpoest W,et al.Live birth rates following natural cycle IVF in women with poor ovarian response according to the Bologna criteria[J].Hum Reprod,2012,27:3481-3486.
[47] Xu YM,Hao GM,Gao BL.Application of growth hormone in in vitro fertilization[J].Front Endocrinol (Lausanne),2019,10:502.
[48] 李月,康晓敏,武泽.生长激素在体外受精助孕中的应用进展[J].中华生殖与避孕杂志,2020,40:129-133.
[49] Tesarik J,Hazout A,Mendoza C.Improvement of delivery and live birth rates after ICSI in women aged >40 years by ovarian co-stimulation with growth hormone[J].Hum Reprod,2005,20:2536-2541.
[50] Weall B,Al-Samerria S,Conceicao J,et al.A direct action for GH in improvement of oocyte quality in poor-responder patients[J].Reproduction,2015,149:147-154.
[51] Hou HY,Wang X,Yu Q,et al.Evidence that growth hormone can improve mitochondrial function in oocytes from aged mice[J].Reproduction,2019,157:345-358.
[52] Altm?e S,Mendoza-Tesarik R,Mendoza C,et al.Effect of growth hormone on uterine receptivity in women with repeated implantation failure in an oocyte donation program:a randomized controlled trial[J].J Endocr Soc,2017,2:96-105.
[53] Cui N,Li AM,Luo ZY,et al.Effects of growth hormone on pregnancy rates of patients with thin endometrium[J].J Endocrinol Invest,2019,42:27-35.
[54] Altm?e S,Aghajanova L.Growth hormone and endometrial receptivity[J].Front Endocrinol (Lausanne),2019,10:653.
[55] Chen Y,Liu F,Nong Y,et al.Clinical efficacy and mechanism of growth hormone action in patients experiencing repeat implantation failure[J].Can J Physiol Pharmacol,2018,96:929-932.
[56] Wang XM,Jiang H,Zhang WX,et al.The effects of growth hormone on clinical outcomes after frozen-thawed embryo transfer[J].Int J Gynecol Obstet,2016,133:347-350.
[57] Bassiouny YA,Dakhly DMR,Bayoumi YA,et al.Does the addition of growth hormone to the in vitro fertilization/intracytoplasmic sperm injection antagonist protocol improve outcomes in poor responders?A randomized,controlled trial[J].Fertil Steril,2016,105:697-702.
[58] Yang P,Wu R,Zhang H.The effect of growth hormone supplementation in poor ovarian responders undergoing IVF or ICSI:a meta-analysis of randomized controlled trials[J].Reprod Biol Endocrinol,2020,18:76.
[59] Cai MH,Gao LZ,Liang XY,et al.The effect of growth hormone on the clinical outcomes of poor ovarian reserve patients undergoing in vitro fertilization/intracytoplasmic sperm injection treatment:a retrospective study based on POSEIDON criteria[J].Front Endocrinol (Lausanne),2019,10:775.
[60] Chen Y,Tao L,Lin Y,et al.Outcomes of in vitro fertilization-embryo transfer in women with diminished ovarian reserve after growth hormone pretreatment[J].Gynecol Endocrinol,2020,36:955-958.
[61] Gong Y,Zhang K,Xiong D,et al.Growth hormone alleviates oxidative stress and improves the IVF outcomes of poor ovarian responders:a randomized controlled trial[J].Reprod Biol Endocrinol,2020,18:91.
[62] Schwarze JE,Canales J,Crosby J,et al.DHEA use to improve likelihood of IVF/ICSI success in patients with diminished ovarian reserve:a systematic review and meta-analysis[J].JBRA Assist Reprod,2018,22:369-374.
[63] Chern CU,Tsui KH,Vitale SG,et al.Dehydroepiandrosterone(DHEA) supplementation improves in vitro fertilization outcomes of poor ovarian responders,especially in women with low serum concentration of DHEA-S:a retrospective cohort study[J].Reprod Biol Endocrinol,2018,16:90.
[64] Al-Turki HA.Dehydroepiandrosterone supplementation in women undergoing assisted reproductive technology with poor ovarian response.A prospective case-control study[J].J Int Med Res,2018,46:143-149.
[65] Wang Z,Yang AJ,Bao HC,et al.Effect of dehydroepiandrosterone administration before IVF on the live birth rate in poor ovarian responders according to the Bologna criteria:a randomized controlled trial[J].BJOG,2021,doi:10.1111/1471-0528.17045.
[66] Kara M,Aydin T,Aran T,et al.Does dehydroepiandrosterone supplementation really affect IVF-ICSI outcome in women with poor ovarian reserve?[J].Eur J Obstet Gynecol Reprod Biol,2014,173:63-65.
[67] Yeung TWY,Chai J,Li RHW,et al.A randomized,controlled,pilot trial on the effect of dehydroepiandrosterone on ovarian response markers,ovarian response,and in vitro fertilization outcomes in poor responders[J].Fertil Steril,2014,102:108-115.
[68] Tanaka T,Huang X,Halicka HD,et al.Cytometry of ATM activation and histone H2AX phosphorylation to estimate extent of DNA damage induced by exogenous agents[J].Cytometry A,2007,71:648-661.
[69] Akarsu S,Gode F,Isik AZ,et al.The association between coenzyme Q10 concentrations in follicular fluid with embryo morphokinetics and pregnancy rate in assisted reproductive techniques[J].J Aassist Reprod Genet,2017,34:599-605.
[70] Turi A,Giannubilo SR,Brugè F,et al.Coenzyme Q10 content in follicular fluid and its relationship with oocyte fertilization and embryo grading[J].Arch Gynecol Obstet,2012,285:1173-1176.
[71] Bentov Y,Hannam T,Jurisicova A,et al.Coenzyme Q10 supplementation and oocyte aneuploidy in women undergoing IVF-ICSI treatment[J].Clin Med insights Reprod Health,2014,8:31-36.
[72] Xu Y,Nisenblat V,Lu C,et al.Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve:a randomized controlled trial[J].Reprod Biol Endocrinol,2018,16:29.
[73] 安东,刘丽敏.补肾类中成药治疗卵巢储备功能下降的Meta分析[J].中国老年学杂志,2021,41:4425-4431.
[74] Liu L,Liu Y,Yang M,et al.Effectiveness of tonifying-kidney and regulating-liver therapy on diminished ovarian reserve:a systematic review and Meta-analysis of randomized controlled trials[J].J Tradit Chin Med,2020,40:343-354.
[75] 罗倩倩,夏桂成,谈勇.高龄妇女生育力减退之备孕策略[J].中华中医药杂志,2021,36:5926-5929.
[76] 邓伟民,赵彦鹏,葛明晓,等.益气血补肝肾中药对体外受精-胚胎移植临床结局的影响[J].辽宁中医药大学学报,2011,13:5-7.
[77] Liu Y,Wu JZ.Effect of Gutai Decoction on the abortion rate of in vitro fertilization and embryo transfer[J].Chin J Integr Med,2006,12:189-193.
[78] Jang S,Kim KH,Jun JH,et al.Acupuncture for in vitro fertilization in women with poor ovarian response:a systematic review[J].Integr Med Res,2020,9:100395.
[79] Davar R,Rahsepar M,Rahmani E.A comparative study of luteal estradiol pre-treatment in GnRH antagonist protocols and in micro dose flare protocols for poor-responding patients[J].Arch Gynecol Obstet,2013,287:149-153.
[80] Fàbregues F,Ferreri J,Méndez M,et al.In vitro follicular activation and stem cell therapy as a novel treatment strategies in diminished ovarian reserve and primary ovarian insufficiency[J].Front Endocrinol(Lausanne),2020,11:617704.
[81] Kawamura K,Ishizuka B,Hsueh AJ.Drug-free in-vitro activation of follicles for infertility treatment in poor ovarian response patients with decreased ovarian reserve[J/OL].Reprod Biomed Online,2020,40:245-253.
[82] Lunding SA,Pors SE,Kristensen SG,et al.Biopsying,fragmentation and autotransplantation of fresh ovarian cortical tissue in infertile women with diminished ovarian reserve[J].Hum Reprod,2019,34:1924-1936.
[83] Herraiz S,Romeu M,Buigues A,et al.Autologous stem cell ovarian transplantation to increase reproductive potential in patients who are poor responders[J].Fertil Steril,2018,110:496-505.
[84] Urman B,Boza A,Balaban B.Platelet-rich plasma another add-on treatment getting out of hand?How can clinicians preserve the best interest of their patients?[J].Hum Reprod,2019,34:2099-2103.
基本信息:
中图分类号:R714.8
引用信息:
[1].卵巢储备功能减退临床诊治专家共识[J].生殖医学杂志,2022,31(04):425-434.