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2015辅助生殖促排卵药物治疗专家共识发布

2016-07-20 MedSci MedSci原创

辅助生殖促排卵药物
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辅助生殖技术(assisted reproductive technology，ART)的重要内容之一是诱导排卵（ovulation induction，OI)和控制性卵巢刺激(controlled ovarian stimulation，COS)，OI指对排卵障碍患者应用药物或手术方法诱发排卵，一般以诱导单卵泡或少数卵泡发育为目的。COS指以药物手段在可控范围内诱发多卵泡发育和成熟，其应用对象多

辅助生殖技术(assisted reproductive technology，ART)的重要内容之一是诱导排卵（ovulation induction，OI)和控制性卵巢刺激(controlled ovarian stimulation，COS)，OI指对排卵障碍患者应用药物或手术方法诱发排卵，一般以诱导单卵泡或少数卵泡发育为目的。COS指以药物手段在可控范围内诱发多卵泡发育和成熟，其应用对象多有正常排卵功能。


辅助生殖技术(ART)的重要内容之一是促排卵治疗，其应用改善了临床妊娠率，但多胎妊娠、卵巢过度刺激综合征(OHSS)等并发症发生几率较高。

促排卵最常用药物为克罗米芬(CC)、芳香化酶抑制剂、促性腺激素（Gn)类和促性腺激素释放激素类似物(GnRHa)，包括激动剂(GnRH-a)和拮抗剂(GnRH-A)近年来的应用也逐渐增加。各种药物有不同的适应证、禁忌证和用药方案，另外还可使用其他促排卵辅助药物，如口服避孕药（OC）、二甲双胍、多巴胺受体激动剂等，这些促排卵治疗效果可通过常用的疗效评估指标及计算方法来统计。

如何合理、适度地应用促排卵药物，制定标准监测评价指标，越来越成为生殖医生临床实践中需要重点考虑的问题。中华医学会生殖医学分会部分专家结合近年来国内、外相关领域研究进展及临床应用，对促排卵药物在ART中的应用达成共识，指导规范的临床应用，以期为临床生殖医学工作者提供更佳的操作依据。

本指南从以下5个方面介绍：

1、辅助生殖促排卵药物治疗的目标 
2 适应证及禁忌证
3 药物的分类及其药理作用
4 辅助生殖药物治疗方案
5 疗效常用的评估指标及计算方法

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相关会议推荐

2016生殖医学发展前沿论坛——健康发育与生殖研究

会议时间：2016.08.19-2016.08.20 会议地点：上海

会议详情： http://www.bioon.com/z/2016repro-med/


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  1. [GetPortalCommentsPageByObjectIdResponse(id=1693145, encodeId=6b001693145b0, content=<a href='/topic/show?id=0ad2566259b' target=_blank style='color:#2F92EE;'>#排卵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56625, encryptionId=0ad2566259b, topicName=排卵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b02429348837, createdName=wangbingxhy, createdTime=Sun Jan 22 22:34:00 CST 2017, time=2017-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1704142, encodeId=5b9b1e04142fd, content=<a href='/topic/show?id=33fc2e0801e' target=_blank style='color:#2F92EE;'>#促排卵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27080, encryptionId=33fc2e0801e, topicName=促排卵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Thu Oct 13 21:34:00 CST 2016, time=2016-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844505, encodeId=f3e2184450598, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Tue Jan 17 15:34:00 CST 2017, time=2017-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93823, encodeId=569c9382389, content=值得阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Jul 20 13:07:00 CST 2016, time=2016-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93821, encodeId=6390938215a, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=174, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Jul 20 13:06:00 CST 2016, time=2016-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93822, encodeId=0c3193822df, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Jul 20 13:06:00 CST 2016, time=2016-07-20, status=1, ipAttribution=)]
    2017-01-22 wangbingxhy

    #排卵#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1693145, encodeId=6b001693145b0, content=<a href='/topic/show?id=0ad2566259b' target=_blank style='color:#2F92EE;'>#排卵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56625, encryptionId=0ad2566259b, topicName=排卵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b02429348837, createdName=wangbingxhy, createdTime=Sun Jan 22 22:34:00 CST 2017, time=2017-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1704142, encodeId=5b9b1e04142fd, content=<a href='/topic/show?id=33fc2e0801e' target=_blank style='color:#2F92EE;'>#促排卵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27080, encryptionId=33fc2e0801e, topicName=促排卵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Thu Oct 13 21:34:00 CST 2016, time=2016-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844505, encodeId=f3e2184450598, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Tue Jan 17 15:34:00 CST 2017, time=2017-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93823, encodeId=569c9382389, content=值得阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Jul 20 13:07:00 CST 2016, time=2016-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93821, encodeId=6390938215a, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=174, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Jul 20 13:06:00 CST 2016, time=2016-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93822, encodeId=0c3193822df, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Jul 20 13:06:00 CST 2016, time=2016-07-20, status=1, ipAttribution=)]
    2016-10-13 heli0118

    #促排卵#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1693145, encodeId=6b001693145b0, content=<a href='/topic/show?id=0ad2566259b' target=_blank style='color:#2F92EE;'>#排卵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56625, encryptionId=0ad2566259b, topicName=排卵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b02429348837, createdName=wangbingxhy, createdTime=Sun Jan 22 22:34:00 CST 2017, time=2017-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1704142, encodeId=5b9b1e04142fd, content=<a href='/topic/show?id=33fc2e0801e' target=_blank style='color:#2F92EE;'>#促排卵#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27080, encryptionId=33fc2e0801e, topicName=促排卵)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Thu Oct 13 21:34:00 CST 2016, time=2016-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844505, encodeId=f3e2184450598, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Tue Jan 17 15:34:00 CST 2017, time=2017-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93823, encodeId=569c9382389, content=值得阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Jul 20 13:07:00 CST 2016, time=2016-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93821, encodeId=6390938215a, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=174, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Jul 20 13:06:00 CST 2016, time=2016-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93822, encodeId=0c3193822df, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Jul 20 13:06:00 CST 2016, time=2016-07-20, status=1, ipAttribution=)]
    2017-01-17 snowpeakxu

    #专家共识#

    0

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    2016-07-20 doctorJiangchao

    值得阅读

    0

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    2016-07-20 doctorJiangchao

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    2016-07-20 doctorJiangchao

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