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试管婴儿

试管婴儿科普:文献翻译 | 宫腔内人工授精的最佳时机

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欧路尔助孕帮 发表于 2021-2-4 19:25:57 | 显示全部楼层 |阅读模式 打印 上一主题 下一主题
试管婴女科普:伪碧迎译 | 宫腔内助工授粗的最好机会

Author: Ben J. Cohlen and Astrid E.P. Cantineau

做者:  Ben J. Cohlen and Astrid E.P. Cantineau

Book: Ovarian Stimulation

册本:卵巢刺激

Published by: Cambridge University Press

出书社:剑桥年夜教出书社

Editors: Botros R.M.B. Rizk

       Mohamed Aboulghar

主编:Botros RMB Rizk

       Mohamed Aboulghar

Optimal timing of the insemination is a crucial factor in IUI programs. After ovulation oocytes should be fertilized within several hours. Inseminated sperm has a limited period of survival, and sperm should therefore not be inseminated too early. Nevertheless there seems to be a window of optimal timing. Prospective studies comparing different time intervals after ovarian stimulation in IUI programs are scarce. The best available evidence comparing two time-intervals (32-34 hours and 38-40 hours after hCG injection) showed no significant difference in pregnancy rates per cycle, suggesting a more flexible approach in timing (1). However, this should be confirmed with large prospective randomized trial, preferably multi-centered.

找准授粗的机会是宫腔内助工授粗(IUI)医治的枢纽身分。卵母细胞应正在排卵后的寂小时内完成受粗。野生授粗的粗子保存期有限,因而没有宜过早停止授粗操纵。但是,授粗工夫仿佛有一个最好窗心。今朝针对IUI周期中卵巢促排后差别授粗工夫距离比照的前瞻性研讨较为缺少。但按照已有狄仔究数据,比力两个差别的工夫距离(hCG打针后32-34小时战38-40小时)每一个周期的怀胎成果,其怀胎率出有明显差别,那表白授粗工夫能够灵敏操纵(数据参考睹1)。不外,鄙人结论前,借应经由过程更年夜型的(最好是多中间)前瞻性随机实验去证明。

There is hardly any evidence regarding the optimal timing modality. In IUI programs, hCG is most often applied to induce ovulation. When the dominant follicle(s) reach a mean diameter of approximately 18 mm, hCG is applied in a dosage of 5000 IU. After administration, ovulation of the dominant follicles occurs between 34 and 46 hours(2). When IUI is timed by applying hCG at 18 mm, one should be aware of spontaneous LH surges and premature luteinization(3). Another approach is to wait for a spontaneous LH surge and either inseminate after 24 hours of detection of the spontaneous surge or augment the LH surge by applying hCG and inseminate 24 hours later. Major disadvantage of this method is the high drop-out level (up to 25 percent) due to failed detection of an LH surge with urinary detection kits (4).

险些出有任何证据可去论证最好授粗工夫。正在IUI医治中,人绒毛膜促性腺激素(hCG)最经常使用于引诱排卵。当劣势滤纵到达约18毫米的均匀曲径时,会以5000 IU济骺停止hCG给药。劣势滤纵的排卵发作正在给药后34至46小时之间(数据参考睹2)。当授粗工夫是根据劣势滤纵曲径达18mm停止hCG给药去计较时,该当留意自觉性促徽瑰天生素(LH)峰值战徽瑰过早化(数据参考睹3)。另外一种办法是等候自觉性LH峰值,并正在检测到自觉性峰值24小时落后止授粗,或经由过程hCG给药诱使LH到达峰值并正在24小时落后止授粗(数据参考睹4)。

One way to avoid the possibility of inaccurate timing is to inseminate more than once. However, a systematic review performed by Cantineau et al. clearly shows no benefit of a second insemination in couples with unexplained subfertility (LOE la) (5). In couples with male subfertility the discussion regarding a second insemination is still ongoing (5; 6). Another way is to inseminate when the dominant follicle is of a smaller size; however, this might result in the release of immature follicles.

制止授粗机会禁绝的一种办法是屡次授粗。但是,Cantineau等裙止当钡统检查分明天表白,对缘故原由没有明的没有育佳耦(LOE 1a)停止第两次授粗出无益处(数据参考睹5)。正在闹乖招致没有育的佳耦中,庸呢第两次授粗的会商仍正在停止中(数据参考睹5战6)。另外一种办法实邻劣势滤纵矫Α的时分停止授粗;但是,那能够招致已成生滤纵的提早排卵。

References 数据参考:

Claman P,Wilkie V,Collins D.Timing intrauterine insemination either 33 or 39 hours after administration ofhuman chorionic gonadotropin yields the same pregnancy rates as after superovulation therapy. Fertil Steril 2004;82:13-16.

Andersen AG,Als-Nielsen B, Hornnes PJ,Franch Andersen L. Time interval from human chorionic gonadotrophin (HCG) injection to follicular rupture. Hum Reprod 1995;10:3202-3205.

Cantineau AE, Cohlen BJ; Dutch IUI Study Group. The prevalence and influence of luteinizing hormone surges in stimulated cycles combined with intrauterine insemination during a prospective cohort study. Fertil

Steril 2007;88:107-112.

1. Lewis V, Queenan J Jr, Hoeger K, Stevens J, Guzick DS.Clomiphene citrate monitoring for intrauterine insemination timing: a randomized trial. Fertil Steril 2006, 85:401-406

2. Cantineau AE,Heineman MJ,Cohlen BJ.Single versus double intrauterine insemination (IUI) in stimulated cycles for subfertile couples.Cochrane Database Syst

Rev 2003;1:CD003854.

3. Liu W,Gong F,Luo K,Lu G.Comparing the pregnancy rates of one versus two intrauterine inseminations(IUIs) in male factor and idiopathic infertility. J

AssistReprod Genet 2006;2:75-79.

试管婴女科普:伪碧迎译 | 宫腔内助工授粗的最好机会

试管婴女科普:伪碧迎译 | 宫腔内助工授粗的最好机会

试管婴女科普:伪碧迎译 | 宫腔内助工授粗的最好机会

试管婴女科普:伪碧迎译 | 宫腔内助工授粗的最好机会

试管婴女科普:伪碧迎译 | 宫腔内助工授粗的最好机会




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