类固醇激素预处理在辅助生殖技术中的应用进展

在卵巢控制性促排卵（COS）过程中,窦卵泡对卵泡刺激素（FSH）的敏感性和充分利用率以及窦卵泡的协调生长是对促排卵效果起决定性作用的两个重要因素。越来越多的证据表明,类固醇激素预处理（复方口服避孕药、人工合成的雌二醇和孕激素）有效抑制或减弱早发的黄体期FSH抬头,使上述两个因素均受到积极影响,这些预处理措施可能对助孕结局产生决定性作用。然而,在COS前常规进行复方口服避孕药预处理或单独使用雌激素或孕激素预处理是否会提高体外受精（IVF）妊娠率和活产率,目前尚缺乏共识。汇总近年来相关临床研究进展,综述复方口服避孕药、雌激素及孕激素预处理在不同类型患者和不同卵巢刺激方案中的应用及其对辅助生殖技术助孕结局的影响。

The Application Progress of Steroid Hormone Pretreatment in Assisted Reproductive Technology

Adequate availability and FSH sensitivity of ovarian antral follicles,and coordination of their growth during controlled ovarian stimulation(COS),are two important factors that play a decisive role in pregnancy outcome.Growing evidence indicates that steroid hormone pretreatments may positively improve both factors by inhibiting or weakening the early rise of FSH at luteal phase.However,there is a lack of consensus on whether the conventional pretreatment with combined oral contraceptive pills(COCP),estrogen or progestin alone before COS will increase the IVF pregnancy rate and live birth rate.This article summarizes the clinical research progress of related topics in recent years,including the application of COCP,estrogen and progesterone pretreatment in different types of patients and different ovarian stimulation protocols,and the impact of hormonal pretreatment on the outcomes of assisted reproduction technology.