Современные методы ведения пациенток с бедным овариальным ответом на контролируемую овариальную стимуляцию: обзор литературы
Ключевые слова:
бедный овариальный ответ , технология вспомогательной репродукции, контролируемая овариальная стимуляция , КОС, адъювантная терапияАннотация
Актуальность: «Бедный» овариальный ответ (БОО) на контролируемую овариальную стимуляцию (КОС) представляет собой значительное препятствие при проведении процедур экстракорпорального оплодотворения. Многие пациентки, проходящие КОС, могут столкнуться с БОО, и в последние годы наблюдается рост этой проблемы среди молодых женщин. Частота БОО среди пациенток, получающих КОС, варьируется от 9% до 24%.
Цель исследования – представить краткий обзор важной информации, ключевых открытий и идей в вопросах терапии пациенток с БОО, включающих адъювантную терапию, при контролируемой овариальной стимуляции.
Материалы и методы: Поиск литературы был произведен по всем типам клинических исследований на русском и английском языках, согласно следующим ключевым словам и фразам, связанным с темой методы введение пациентов с БОО: "бедный овариальный ответ", "адъювантная терапия", "группа Poseidon", "контролируемая овариальная стимуляция", "технология вспомогательной репродукции". В рамках обзора использовались такие научные базы данных, как PubMed, Scopus, Web of Science и Google Scholar. Критерии отбора литературы включали актуальность (публикации, посвященные настоящей теме не старше 10 лет) и релевантность исследований теме обзора, а также доступность полных текстов статей.
Результаты: В некоторых случаях гормональная и адъювантная терапия показала лучшие результаты по сравнению с реакцией яичников при альтернативном протоколе стимуляции.
Заключение: Данный обзор показывает, что предложенные терапии стратегии и фармацевтические методы лечения БОО значительно увеличивают количество яйцеклеток, извлекаемых в течение овариального цикла, количество жизнеспособных эмбрионов и показатели живорождаемости. Эти результаты свидетельствуют, что дополнительное адъювантное лечение (Мио-инозитол, Коэнзим Q10) и гормональная терапия (ДГЭА) в ходе КОС является оптимальным методом ведения пациенток с БОО.
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