摘要
卵巢低反应(POR)是指在控制性卵巢刺激(COS)中卵巢对外源性FSH的反应性下降,表现为获卵数减少,取消率增加和妊娠率下降。引起POR的常见原因包括:卵巢储备功能减退(DOR),FSH受体表达不足,FSH受体基因多态性及LH基因变异。增加FSH剂量是POR的常用治疗方法,但FSH剂量增加至多少是极限并无统一意见,300U/d是POR较为常用的极限剂量。过高FSH剂量并无益处,原因:当FSH受体达饱和或FSH受体处于降调状态时,增加FSH剂量不能改善卵巢反应性;此外,大剂量FSH还可能增加胚胎的非整倍体率,而可利用胚胎数并无增加。
Poor ovarian response（POR）to controlled ovarian stimulations（COS）usually indicates a reduction in follicular response,resulting in a reduced number of retrieved oocytes,which is related to increasing cycle cancellation rate and decreasing pregnancy rate.The common causes include：decreased ovarian reserve,insufficient express of FSH receptor,FSH receptor gene polymorphisms,and LH gene variant.Increasing daily FSH dose is a very logical approach to treat these patients.There is no consensus what the highest FSH dose for COS is.However,the upper limit of FSH dose generally is 300U/day.It has been demonstrated that excessive FSH dose used is lack of benefit.The possible explanations could be desensitization of FSH receptors during prolonged gonadotropin exposure,FSH receptor saturated,and a negative impact of high doses of gonadotropins on oocyte/embryo quality.
出处
《生殖医学杂志》
CAS
2015年第10期808-810,共3页
Journal of Reproductive Medicine
关键词
卵巢低反应
FSH极限剂量
Poor ovarian response（POR）
Upper limit of FSH dose
