[医学保健]Ovarian Stimulation for IVF Procedures.pptVIP

Ovarian Stimulation for IVF Procedures Dr Milton Leong 梁家康醫生 微剂量Flare法(1) 口服避孕药 皮下注射20mcg 亮丙瑞林 （一天两次）X2天 应用uFSH 以刺激卵巢 结果: ? 卵母细胞 FSH使用量少 Source: Scott et al, 1994 微剂量Flare法(2) 口服避孕药 皮下注射40mcg 亮丙瑞林 （一天两次） 肌注4 IU/d 生长激素 使用uFSH 2 天后监测 结果: ? 取消率 ? E2 浓度, 卵母细胞数目 Source: Schoolcraft et al, 1997 微剂量Flare法(3) 口服避孕药 皮下注射40mcg 亮丙瑞林 （一天两次） 2天后开始应用uFSH 结果: ? 取消率 ? E2, 卵母细胞数目 Source: Surrey et al, 1998 延长停药时间 (1) 目的: 避免过度刺激 临床: 直至 E2 ? 3000 pg/mL停药 延长停药时间(2) Sher, 1995 当30% 卵泡 15mm开始 Nilsson, 1999 当3 个卵泡 17mm开始 * * 精品PPT课件 浏览免费 下载后可以编辑修改。 /jn-lxh /lianer2012 / / / Source: Janssens et al, 1998 0 0 0 3 排卵 0.9 1.8 2.3 2.5 HCG-LH 0.8 1.3 1.5 3.3 S7-LH 28.5 27 22.5 24 FSH使用量 10.5 10 7.5 9 刺激天数 12 11 10 11 病例数 100 50 15 5 曲普瑞林 (mcg) GnRHa 剂量组 Mean SE ? E2 and LH conc. Before and during the coasting period in superovluation cycles Characteristics of representative IVF-ET cycles in which coasting was used General Principles of combined pituitary suppression / ovarian stimulation therapy (From Insler and Lunenfeld) Crude pregnancy rates using different GnRH agonist protocols in IVF (From Daya) The structure of GnRH agonistic analogues Outcome results according to type of protocol and gonadotrophin used (n=13426) Oocyte damage, pronuclear status and embryo cleavage after ICSI Trade names, plasma half-lives, relate potency, route of administration and recommended dose for the clinically available gonadotrophins Proposed protocols for poor responders Characteristics of IVF-ET cycles in which follicular maturity was attained before (gp 2A) or after (gp 2B) the coasting period Gonadotropin and ovarian steroid hormone levels with microdose flare regimen: gonadotropin treatment day 1 vs day 6 Comparison of conventional IVF and ICSI procedure on sibling oocytes of 50 patients with tubal infertility