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Экстракорпоральное оплодотворение в естественном цикле
Экстракорпоральное оплодотворение в естественном цикле
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Аннотация
В статье, демонстрирующей результаты собственных исследований, представлены данные об аспектах проведения программ экстракорпорального оплодотворения (ЭКО) в естественном цикле по сравнению со стандартным ЭКО. Показаны преимущества реализации ЭКО в натуральном цикле на основании сравнения эффективности проведения данных протоколов. Особое внимание уделено зависимости параметров фолликуло-, оогенеза и эмбриогенеза от возраста пациенток и кратности попыток. Рассмотрены пути снижения частоты осложнений, связанных с применением стимуляции суперовуляции, применяемых в стандартном ЭКО. Подчеркнута необходимость пересмотра критериев отбора супружеских пар для проведения ЭКО в естественном цикле с целью оптимизации здоровья матери и ребенка.
Ключевые слова: естественный цикл, ЭКО, стимуляция суперовуляции.
Key words: in vitro fertilization in natural cycle, IVF, ovarian stimulation.
Ключевые слова: естественный цикл, ЭКО, стимуляция суперовуляции.
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Key words: in vitro fertilization in natural cycle, IVF, ovarian stimulation.
Полный текст
Список литературы
1.Bassil S, Godin PA, Donnez J. Outcome of in-vitro fertilization through natural cycles in poor responders. Hum Reprod 1999; 14: 1262–5.
2. Rongieres-Bertrand C, Olivennes F, Righini C et al. Revival of the natural cycles in in-vitro fertilization with the use of a new gonadotrophin-releasing hormone antagonist (Cetrorelix): a pilot study with minimal stimulation. Hum Reprod 1999; 14: 683–8.
3. Janssens RM, Lambalk CB, Vermeiden JP et al. Invitro fertilization in a spontaneous cycle: easy, cheap and realistic. Hum Reprod 2000; 15: 314–8.
4. Nargund G, Waterstone J, Bland J et al. Cumulative conception and live birth rates in natural (unstimulated) IVF cycles. Hum Reprod 2001; 16: 259–62.
5. Ng EH, Chui DK, Tang OS et al. In vitro fertilization and embryo transfer during natural cycles. J Reprod Med 2001; 46: 95–9.
6. Omland AK, Fedorcsak P, Storeng R et al. Natural cycle IVF in unexplained, endometriosis-associated and tubal factor infertility. Hum Reprod 2001; 16: 2587–92.
7. Pelinck MJ, Hoek A, Simons AH, Heineman MJ. Efficacy of natural cycle IVF: a review of the literature. Hum Reprod Update 2002; 8: 129–39.
8. Pelinck MJ, Vogel NE, Hoek A et al. Minimal stimulation IVF with late follicular phase administration of the GnRH antagonist cetrorelix and concomitant substitution with recombinant FSH: a pilot study. Hum Reprod 2005; 20: 642–8.
9. Pelinck MJ, Vogel NE, Hoek A et al. Cumulative pregnancy rates after three cycles of minimal stimulation IVF and results according to subfertility diagnosis: a multicentre cohort study. Hum Reprod 2006; 21: 2375–83.
10. Pelinck MJ, Vogel NE, Arts EG et al. Cumulative pregnancy rates after a maximum of nine cycles of modified natural cycle IVF and analysis of patient drop-out: a cohort study. Hum Reprod 2007; 22: 2463–70.
11. Kolibianakis E, Zikopoulos K, Camus M et al. Modified natural cycle for IVF does not offer a realistic chance of parenthood in poor responders with high day 3 FSH levels, as a last resort prior to oocyte donation. Hum Reprod 2004; 19: 2545–9.
12. Hanoch J, Lavy Y, Holzer H et al. Young low responders protected from untoward effects of reduced ovarian response. Fertil Steril 1998; 69: 1001–4.
13. Pellicer A, Lightman A, Diamond MP et al. Outcome of in vitro fertilization in women with low response to ovarian stimulation. Fertil Steril 1987; 47: 812–5.
14. Pellicer A, Ballester MJ, Serrano MD et al. Aetiological factors involved in the low response to gonadotrophins in infertile women with normal basal serum follicle stimulating hormone levels. Hum Reprod 1994; 9: 806–11.
15. Jacobs SL, Metzger DA, Dodson WC. Haney AF.Effect of age on response to human menopausal gonadotropin stimulation. J Clin Endocrinol Metab 1990; 71: 1525–30.
16. Karande V, Gleicher N. The diameter of the proximal tube – large enough for a single sperm or do you need more? Fertil Steril 1999; 72: 950–1.
17. Jenkins JM, Davies DW, Devonport H et al. Comparison of ‘poor’ responders with ‘good’ responders using a standard buserelin/human menopausal gonadotrophin regime for in-vitro fertilization. Hum Reprod 1991; 6: 918–21.
18. Janssens RM, Lambalk CB, Schats R, Schoemaker J. Successful in-vitro fertilization in a natural cycle after four previously failed attempts in stimulated cycles: case report. Hum Reprod 1999; 14: 2497–8.
2. Rongieres-Bertrand C, Olivennes F, Righini C et al. Revival of the natural cycles in in-vitro fertilization with the use of a new gonadotrophin-releasing hormone antagonist (Cetrorelix): a pilot study with minimal stimulation. Hum Reprod 1999; 14: 683–8.
3. Janssens RM, Lambalk CB, Vermeiden JP et al. Invitro fertilization in a spontaneous cycle: easy, cheap and realistic. Hum Reprod 2000; 15: 314–8.
4. Nargund G, Waterstone J, Bland J et al. Cumulative conception and live birth rates in natural (unstimulated) IVF cycles. Hum Reprod 2001; 16: 259–62.
5. Ng EH, Chui DK, Tang OS et al. In vitro fertilization and embryo transfer during natural cycles. J Reprod Med 2001; 46: 95–9.
6. Omland AK, Fedorcsak P, Storeng R et al. Natural cycle IVF in unexplained, endometriosis-associated and tubal factor infertility. Hum Reprod 2001; 16: 2587–92.
7. Pelinck MJ, Hoek A, Simons AH, Heineman MJ. Efficacy of natural cycle IVF: a review of the literature. Hum Reprod Update 2002; 8: 129–39.
8. Pelinck MJ, Vogel NE, Hoek A et al. Minimal stimulation IVF with late follicular phase administration of the GnRH antagonist cetrorelix and concomitant substitution with recombinant FSH: a pilot study. Hum Reprod 2005; 20: 642–8.
9. Pelinck MJ, Vogel NE, Hoek A et al. Cumulative pregnancy rates after three cycles of minimal stimulation IVF and results according to subfertility diagnosis: a multicentre cohort study. Hum Reprod 2006; 21: 2375–83.
10. Pelinck MJ, Vogel NE, Arts EG et al. Cumulative pregnancy rates after a maximum of nine cycles of modified natural cycle IVF and analysis of patient drop-out: a cohort study. Hum Reprod 2007; 22: 2463–70.
11. Kolibianakis E, Zikopoulos K, Camus M et al. Modified natural cycle for IVF does not offer a realistic chance of parenthood in poor responders with high day 3 FSH levels, as a last resort prior to oocyte donation. Hum Reprod 2004; 19: 2545–9.
12. Hanoch J, Lavy Y, Holzer H et al. Young low responders protected from untoward effects of reduced ovarian response. Fertil Steril 1998; 69: 1001–4.
13. Pellicer A, Lightman A, Diamond MP et al. Outcome of in vitro fertilization in women with low response to ovarian stimulation. Fertil Steril 1987; 47: 812–5.
14. Pellicer A, Ballester MJ, Serrano MD et al. Aetiological factors involved in the low response to gonadotrophins in infertile women with normal basal serum follicle stimulating hormone levels. Hum Reprod 1994; 9: 806–11.
15. Jacobs SL, Metzger DA, Dodson WC. Haney AF.Effect of age on response to human menopausal gonadotropin stimulation. J Clin Endocrinol Metab 1990; 71: 1525–30.
16. Karande V, Gleicher N. The diameter of the proximal tube – large enough for a single sperm or do you need more? Fertil Steril 1999; 72: 950–1.
17. Jenkins JM, Davies DW, Devonport H et al. Comparison of ‘poor’ responders with ‘good’ responders using a standard buserelin/human menopausal gonadotrophin regime for in-vitro fertilization. Hum Reprod 1991; 6: 918–21.
18. Janssens RM, Lambalk CB, Schats R, Schoemaker J. Successful in-vitro fertilization in a natural cycle after four previously failed attempts in stimulated cycles: case report. Hum Reprod 1999; 14: 2497–8.
2. Rongieres-Bertrand C, Olivennes F, Righini C et al. Revival of the natural cycles in in-vitro fertilization with the use of a new gonadotrophin-releasing hormone antagonist (Cetrorelix): a pilot study with minimal stimulation. Hum Reprod 1999; 14: 683–8.
3. Janssens RM, Lambalk CB, Vermeiden JP et al. Invitro fertilization in a spontaneous cycle: easy, cheap and realistic. Hum Reprod 2000; 15: 314–8.
4. Nargund G, Waterstone J, Bland J et al. Cumulative conception and live birth rates in natural (unstimulated) IVF cycles. Hum Reprod 2001; 16: 259–62.
5. Ng EH, Chui DK, Tang OS et al. In vitro fertilization and embryo transfer during natural cycles. J Reprod Med 2001; 46: 95–9.
6. Omland AK, Fedorcsak P, Storeng R et al. Natural cycle IVF in unexplained, endometriosis-associated and tubal factor infertility. Hum Reprod 2001; 16: 2587–92.
7. Pelinck MJ, Hoek A, Simons AH, Heineman MJ. Efficacy of natural cycle IVF: a review of the literature. Hum Reprod Update 2002; 8: 129–39.
8. Pelinck MJ, Vogel NE, Hoek A et al. Minimal stimulation IVF with late follicular phase administration of the GnRH antagonist cetrorelix and concomitant substitution with recombinant FSH: a pilot study. Hum Reprod 2005; 20: 642–8.
9. Pelinck MJ, Vogel NE, Hoek A et al. Cumulative pregnancy rates after three cycles of minimal stimulation IVF and results according to subfertility diagnosis: a multicentre cohort study. Hum Reprod 2006; 21: 2375–83.
10. Pelinck MJ, Vogel NE, Arts EG et al. Cumulative pregnancy rates after a maximum of nine cycles of modified natural cycle IVF and analysis of patient drop-out: a cohort study. Hum Reprod 2007; 22: 2463–70.
11. Kolibianakis E, Zikopoulos K, Camus M et al. Modified natural cycle for IVF does not offer a realistic chance of parenthood in poor responders with high day 3 FSH levels, as a last resort prior to oocyte donation. Hum Reprod 2004; 19: 2545–9.
12. Hanoch J, Lavy Y, Holzer H et al. Young low responders protected from untoward effects of reduced ovarian response. Fertil Steril 1998; 69: 1001–4.
13. Pellicer A, Lightman A, Diamond MP et al. Outcome of in vitro fertilization in women with low response to ovarian stimulation. Fertil Steril 1987; 47: 812–5.
14. Pellicer A, Ballester MJ, Serrano MD et al. Aetiological factors involved in the low response to gonadotrophins in infertile women with normal basal serum follicle stimulating hormone levels. Hum Reprod 1994; 9: 806–11.
15. Jacobs SL, Metzger DA, Dodson WC. Haney AF.Effect of age on response to human menopausal gonadotropin stimulation. J Clin Endocrinol Metab 1990; 71: 1525–30.
16. Karande V, Gleicher N. The diameter of the proximal tube – large enough for a single sperm or do you need more? Fertil Steril 1999; 72: 950–1.
17. Jenkins JM, Davies DW, Devonport H et al. Comparison of ‘poor’ responders with ‘good’ responders using a standard buserelin/human menopausal gonadotrophin regime for in-vitro fertilization. Hum Reprod 1991; 6: 918–21.
18. Janssens RM, Lambalk CB, Schats R, Schoemaker J. Successful in-vitro fertilization in a natural cycle after four previously failed attempts in stimulated cycles: case report. Hum Reprod 1999; 14: 2497–8.
________________________________________________
2. Rongieres-Bertrand C, Olivennes F, Righini C et al. Revival of the natural cycles in in-vitro fertilization with the use of a new gonadotrophin-releasing hormone antagonist (Cetrorelix): a pilot study with minimal stimulation. Hum Reprod 1999; 14: 683–8.
3. Janssens RM, Lambalk CB, Vermeiden JP et al. Invitro fertilization in a spontaneous cycle: easy, cheap and realistic. Hum Reprod 2000; 15: 314–8.
4. Nargund G, Waterstone J, Bland J et al. Cumulative conception and live birth rates in natural (unstimulated) IVF cycles. Hum Reprod 2001; 16: 259–62.
5. Ng EH, Chui DK, Tang OS et al. In vitro fertilization and embryo transfer during natural cycles. J Reprod Med 2001; 46: 95–9.
6. Omland AK, Fedorcsak P, Storeng R et al. Natural cycle IVF in unexplained, endometriosis-associated and tubal factor infertility. Hum Reprod 2001; 16: 2587–92.
7. Pelinck MJ, Hoek A, Simons AH, Heineman MJ. Efficacy of natural cycle IVF: a review of the literature. Hum Reprod Update 2002; 8: 129–39.
8. Pelinck MJ, Vogel NE, Hoek A et al. Minimal stimulation IVF with late follicular phase administration of the GnRH antagonist cetrorelix and concomitant substitution with recombinant FSH: a pilot study. Hum Reprod 2005; 20: 642–8.
9. Pelinck MJ, Vogel NE, Hoek A et al. Cumulative pregnancy rates after three cycles of minimal stimulation IVF and results according to subfertility diagnosis: a multicentre cohort study. Hum Reprod 2006; 21: 2375–83.
10. Pelinck MJ, Vogel NE, Arts EG et al. Cumulative pregnancy rates after a maximum of nine cycles of modified natural cycle IVF and analysis of patient drop-out: a cohort study. Hum Reprod 2007; 22: 2463–70.
11. Kolibianakis E, Zikopoulos K, Camus M et al. Modified natural cycle for IVF does not offer a realistic chance of parenthood in poor responders with high day 3 FSH levels, as a last resort prior to oocyte donation. Hum Reprod 2004; 19: 2545–9.
12. Hanoch J, Lavy Y, Holzer H et al. Young low responders protected from untoward effects of reduced ovarian response. Fertil Steril 1998; 69: 1001–4.
13. Pellicer A, Lightman A, Diamond MP et al. Outcome of in vitro fertilization in women with low response to ovarian stimulation. Fertil Steril 1987; 47: 812–5.
14. Pellicer A, Ballester MJ, Serrano MD et al. Aetiological factors involved in the low response to gonadotrophins in infertile women with normal basal serum follicle stimulating hormone levels. Hum Reprod 1994; 9: 806–11.
15. Jacobs SL, Metzger DA, Dodson WC. Haney AF.Effect of age on response to human menopausal gonadotropin stimulation. J Clin Endocrinol Metab 1990; 71: 1525–30.
16. Karande V, Gleicher N. The diameter of the proximal tube – large enough for a single sperm or do you need more? Fertil Steril 1999; 72: 950–1.
17. Jenkins JM, Davies DW, Devonport H et al. Comparison of ‘poor’ responders with ‘good’ responders using a standard buserelin/human menopausal gonadotrophin regime for in-vitro fertilization. Hum Reprod 1991; 6: 918–21.
18. Janssens RM, Lambalk CB, Schats R, Schoemaker J. Successful in-vitro fertilization in a natural cycle after four previously failed attempts in stimulated cycles: case report. Hum Reprod 1999; 14: 2497–8.
Авторы
Л.М.Казарян, К.У.Алиева, В.Ю.Смольникова, О.Е.Краснощока, Е.А.Калинина
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздравсоцразвития РФ
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздравсоцразвития РФ
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