en فعال سازی آزمایشگاهی بدون دارو و پیوند اتولوگ در زنان نابارور با کاهش ذخیره تخمدان: یک مطالعه ی تجربی پیلوت Fertility & Infertility Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">پاسخ ضعیف تخمدان و کاهش ذخایر تخمدانی (</span></span><span dir="LTR" style="font-size:10.0pt">DOR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) به طور قابل توجهی در ناباروری زنان نقش دارد. راه&shy;های درمانی مختلفی برای افزایش رشد فولیکولی و بهبود نتایج بارداری در این بیماران انجام شده است.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه با هدف بررسی اثربخشی روش فعال‌سازی بدون دارو در شرایط آزمایشگاهی رزرو تخمدان و نتایج چرخه تحریک لقاح آزمایشگاهی در بیماران </span></span><span dir="LTR" style="font-size:10.0pt">DOR</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مراجعه‌کننده به مرکز ناباروری طالقانی انجام شد.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش&shy; ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مرحله مقدماتی از یک مطالعه پایلوت تجربی به بررسی تأثیر فعال‌سازی آزمایشگاهی (</span></span><span dir="LTR" style="font-size:10.0pt">IVA</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) بر رزرو تخمدان و پیامدهای لقاح آزمایشگاهی در 10 زن نابارور با </span></span><span dir="LTR" style="font-size:10.0pt">DOR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> در مرکز ناباروری طالقانی تهران از اردیبهشت تا شهریور ماه سال 1402 پرداخت. شرکت&shy;کنندگان تحت عمل جراحی لاپاراسکوپی قرار گرفتند که شامل برداشتن بخشی از یک تخمدان، انتقال فوری به آزمایشگاه، تشریح به مکعب&shy;های کوچک و سپس کاشت مجدد در تخمدان بیمار بود. پیامدهای اولیه شامل تعداد تخمک‌های بازیابی شده، تعداد تخمک‌هایی که به متافاز می‌رسند، و پیامدهای ثانویه تعداد و کیفیت جنین‌های منتقل‌شده، میزان لانه‌گزینی و وقوع حاملگی بالینی بود.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه افزایش معنی‌داری را در تعداد فولیکول آنترال قبل و بعد از </span></span><span dir="LTR" style="font-size:10.0pt">IVA</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> نشان داد (033/0 </span></span><span lang="FA" style="font-size:10.0pt">=</span><span dir="LTR" style="font-size:10.0pt">p</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). قبل از </span></span><span dir="LTR" style="font-size:10.0pt">IVA</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، سطح متوسط استرادیول (0/57) 5/93 بود که پس از </span></span><span dir="LTR" style="font-size:10.0pt">IVA</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> به (0/35) 0/79 کاهش یافت که نشان&shy;دهنده تفاوت آماری معنی&shy;دار است. به طور متوسط (8/0) 3/2 تخمک بازیابی شد که از میان آن&shy;ها (7/0) 5/1 تخمک متافاز </span></span><span dir="LTR" style="font-size:10.0pt">II</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> بود. میزان بارداری مشاهده شده در بین دو بیمار 2/22% بود.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه &shy;گیری: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مطالعه حاضر نشان می‌دهد که </span></span><span dir="LTR" style="font-size:10.0pt">IVA</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> ممکن است اثرات مطلوبی بر رشد فولیکولی و پیامدهای بارداری در زنان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">DOR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> داشته باشد.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Background:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> Poor ovarian response and diminished ovarian reserves (DOR) significantly contribute to female infertility. Previous attempts have been made to enhance follicular growth and improve pregnancy outcomes in these participants. </span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Objective:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> This study aimed to assess the efficacy of the in vitro drug-free activation technique of the ovarian reservation and in vitro fertilization stimulation cycle outcomes in DOR participants.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Materials and Methods:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> This pilot phase study investigated the impact of in vitro activation (IVA) on ovarian reservation and in vitro fertilization outcome in 10 infertile women with DOR from May to December 2023 at Taleghani Infertility Center, Tehran, Iran. Participants underwent general surgery and laparoscopy, involving the removal of a portion of one ovary, immediate transfer to the laboratory, dissection into small cubes, and subsequent re-implantation into the cases&rsquo;s ovary. The primary outcomes, include the count of retrieved oocytes, the number of oocytes reaching metaphase, and the secondary outcomes were the quantity and the number of embryos transferred, implantation rate, and occurrence of clinical pregnancy. </span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Results:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> The study revealed a significant increase in the antral follicle count before and after IVA (p = 0.033). Before IVA, the median estradiol level was 93.5 (57.0), which reduced to 79.0 (35.0) after IVA, indicating a statistically significant difference. On average, 2.3 (0.8) oocytes were retrieved, among which 1.5 (0.7) were metaphase II oocytes. The observed pregnancy rate among the 2 cases was 22.2%.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> The current study suggests that IVA may positively impact follicular growth and pregnancy outcomes among women with DOR. </span></span></span></span></span></div> لقاح آزمایشگاهی, پیوند اتولوگ, ناباروری, ذخیره تخمدان. In vitro fertilization, Autologous transplantation, Infertility, Ovarian reserve. 425 432 http://ijrm.ir/browse.php?a_code=A-10-2185-5&slc_lang=en&sid=1 Saghar Salehpour saghar.salehpour2014@gmail.com 0000-0003-3203-8444 No Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mahsa Kazemi M.kazemi@sbmu.ac.ir 0000-0001-9292-5315 No Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sedigheh Hosseini Shoseini@sbmu.ac.ir 0000-0002-4191-0196 No Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Nazanin Hajizadeh Hajizadeh.nazanin94@yahoo.com 0000-0001-6689-1852 Yes Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Bahareh Karimi karimi.b1367@gmail.com 0000-0002-3820-9462 No Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Hajar Abbasi haabbasi65@gmail.com 0000-0001-9331-7258 No Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mitra Nemati mithraa.nemati@gmail.com 0000-0001-9373-1774 No Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Samaneh Esmaeili dresmaeiloi@gmail.com 0000-0001-5990-116x No Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Hasti Ziaee hziaee@uclan.ac.uk 0000-0003-2187-0032 No School of Medicine, University of Central Lancashire, Preston, United Kingdom.