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在控制性促排卵(controlled ovarian stimulation,COS)中,促卵泡生成素(FSH)联合高纯度尿促性腺激素(HP-hMG)促排卵的理论基础是基于促黄体生成素(LH)具有协同FSH促进卵泡发育和卵子成熟的作用。COS通常采用促性腺激素释放激素激动剂(GnRH-a)或促性腺激素释放激素抑制剂(GnRH-A)抑制早发内源性LH峰,致内源性LH水平降低,尤其在卵泡发育中晚期随着颗粒细胞上LH受体增加,对生理性LH的需求也增加。因此,理论上COS中FSH促排卵同时配伍一定量的LH活性制剂(如:HP-hMG,商品名为贺美奇)可能有利于改善COS结局。但目前FSH联合hMG应用的报道并不多,从目前有限的数据显示FSH联合hMG的多样化配伍方案均可获得满意的临床结果,关键是需要针对每个个体制定个体化的COS方案。
In the controlled ovarian stimulation (COS), the theoretical basis of ovulation induced by follicle-stimulating hormone (FSH) combined with high-purity urinary gonadotropin (HP-hMG) is based on that luteinizing hormone (LH) Promote follicular development and egg maturation. COS generally inhibits the early onset endogenous LH peak with a gonadotropin-releasing hormone agonist (GnRH-a) or a gonadotropin-releasing hormone inhibitor (GnRH-A), resulting in a decrease in endogenous LH levels, particularly during follicular development As late LH receptors on granulosa cells increase, the demand for physiological LH also increases. Therefore, it is theoretically possible that FSH promoting ovulation in COS and a certain amount of LH active preparation (eg, HP-hMG, under the trade name Hemeiqi) may be beneficial to improve the outcome of COS. However, there are few reports on the application of FSH in combination with hMG. From the limited data available at present, satisfactory clinical results can be obtained from various combinations of FSH and hMG. The key point is that individualized COS solutions need to be formulated for each individual.