akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2023.394akusherstvo-1654Research ArticleОRIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИOvarian stimulation methods at a single-assisted reproductive technology institution: a retrospective study of successful outcomesМетоды стимуляции яичников в клинике репродуктивной медицины: ретроспективное исследование успешных результатовhttps://orcid.org/0000-0003-0343-5731ХорибэЮ.HoribeY.

Хорибэ Ю – д.м.н., доцент кафедры акушерства и гинекологии

162-8666 Токио, Синдзюку, Кавада-чо, 8–1

Yu Horibe – PhD, Associate Professor, Department of Obstetrics and Gynecology

8–1 Kawada-cho, Shinjuku, Tokyo 162-8666

НакабаяшиА.NakabayashiA.

Накабаяши Акира – д.м.н., доцент кафедры акушерства и гинекологии

162-8666 Токио, Синдзюку, Кавада-чо, 8–1

Akira Nakabayashi – PhD, Associate Professor, Department of Obstetrics and Gynecology

8–1 Kawada-cho, Shinjuku, Tokyo 162-8666

nakabayashi.akira@twmu.ac.jpМуратаШ.MurataS.

Мурата Шуко – д.м.н., доцент кафедры акушерства и гинекологии

162-8666 Токио, Синдзюку, Кавада-чо, 8–1

Shuko Murata – MD, Associate Professor, Department of Obstetrics and Gynecology

8–1 Kawada-cho, Shinjuku, Tokyo 162-8666

ХашимотоТ.HashimotoT.

Хашимото Томоми – д.м.н., доцент кафедры акушерства и гинекологии

162-8666 Токио, Синдзюку, Кавада-чо, 8–1

Tomomi Hashimoto – MD, Associate Professor, Department of Obstetrics and Gynecology

8–1 Kawada-cho, Shinjuku, Tokyo 162-8666

ТабатаЦ.TabataT.

Табата Цутому – д.м.н., профессор кафедры акушерства и гинекологии

162-8666 Токио, Синдзюку, Кавада-чо, 8–1

Tsutomu Tabata – PhD, Professor, Department of Obstetrics and Gynecology

8–1 Kawada-cho, Shinjuku, Tokyo 162-8666

Токийский женский медицинский университетЯпонияTokyo Women's Medical UniversityJapan202322052023172252256Copyright © Horibe Y., Nakabayashi A., Murata S., Hashimoto T., Tabata T., 20232023Хорибэ Ю., Накабаяши А., Мурата Ш., Хашимото Т., Табата Ц.Horibe Y., Nakabayashi A., Murata S., Hashimoto T., Tabata T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/1654Aim

Aim: to examine an efficacy of various stimulation methods in a group of successful pregnancies.

Materials and Methods

Materials and Methods. In a single center retrospective study 47 pregnancy cases were examined after performing embryo transfers at our institution from the years 2017 to 2021. Patients were divided into four groups: i) clomiphene hyperstimulation (CH), ii) stimulation with gonadotropin-releasing hormone (GnRH) agonist, iii) with GnRH antagonist, and iv) progestin-primed ovarian stimulation (PPOS). Age, anti-Mullerian hormone, presence of chronic disease, number of in-vitro fertilizations prior to conception, dosage of follicle stimulating hormone (FSH), presence of premature luteinizing hormone surge, number of egg retrievals, fertilization rate, and live birth rate were assessed.

Results

Results. The number of pregnancies obtained by CH, agonist, antagonist, and PPOS methods comprised 25, 12, 2, and 8 cases, respectively. No significant difference in parameters between CH group and non-CH groups, excepting FSH was observed. The FSH was used in CH group and non-CH group at dose of 1108 ± 468 IU and 1756 ± 394 IU, respectively (p < 0.0001).

Conclusion

Conclusion. CH is not commonly used due to potential luteal phase defects, but it is thought to be cost-effective, requiring lower FSH doses, requiring no ovulation suppression antagonists, and exerting no effect on frozen embryos or fetuses. Hence, CH could be a suitable protocol for egg retrieval in Japan.

Цель

Цель: изучить эффективность различных методов стимуляции яичников в группе успешных беременностей.

Материалы и методы

Материалы и методы. В рамках одноцентрового ретроспективного исследования с 2017 по 2021 гг. нами было изучено 47 случаев беременности после переноса эмбрионов. Пациентки были разделены на 4 группы: 1) кломифеновая гиперстимуляция (КГ) яичников, 2) стимуляция агонистом гонадотропин-рилизинг-гормона (ГнРГ), 3) стимуляция антагонистом ГнРГ и 4) прогестин-праймированная стимуляция яичников (ППСЯ). Оценивали возраст пациенток, уровень антимюллерова гормона, наличие хронических заболеваний, количество попыток экстракорпорального оплодотворения до зачатия, дозу фолликулостимулирующего гормона (ФСГ), наличие преждевременного всплеска лютеинизирующего гормона, количество извлечений яйцеклеток, частоту оплодотворения и частоту живорождения.

Результаты

Результаты. Количество беременностей, наступивших при использовании метода КГ, стимуляции яичников агонистами ГнРГ, антагонистами ГнРГ и метода ППСЯ, составили 25, 12, 2 и 8 случаев соответственно. Не установлено существенной разницы в изученных параметрах между группами с КГ и без таковой, за исключением ФСГ, который применяли в группах с КГ и без таковой в дозе 1108 ± 468 МЕ и 1756 ± 394 МЕ соответственно (p < 0,0001).

Заключение

Заключение. КГ обычно не используется из-за возможного нарушения лютеиновой фазы, но считается, что она экономически эффективна, требует более низких доз ФСГ, не требует применения антагонистов ГнРГ, подавляющих овуляцию, и не оказывает влияния на замороженные эмбрионы или плоды. Следовательно, в Японии метод КГ может быть признан подходящим протоколом для извлечения яйцеклеток.

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The authors declare that there are no conflicts of interest present.