International Journal of Reproductive BioMedicine
International Journal of Reproductive BioMedicine
IJRM
Medical Sciences
http://ijrm.ir
1
admin
2476-4108
2476-3772
10.29252/ijrm
en
jalali
1404
9
1
gregorian
2025
12
1
23
12
online
1
fulltext
en
مقایسه نتایج تزریق داخل سیتوپلاسمی اسپرم و لقاح آزمایشگاهی در پروتکل دو نوبتی تحریک تخمدان با سیکل آنتاگونیست معمول در افراد با ذخیره تخمدانی پایین با حداقل تزریق: یک کارآزمایی بالینی تصادفی
Comparison of intracytoplasmic sperm injection and in vitro fertilization outcomes in double stimulation with conventional protocol in participants with poor ovarian response with minimal injection: An RCT
Assisted Reproductive Technologies
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:">در زنان با ذخیره تخمدانی پایین (</span></span><span dir="LTR" style="font-size:10.0pt">POR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">)، کمیت و کیفیت تخمکهای تولید­شده توسط تخمدان کاهش مییابد که باعث کاهش کیفیت جنینها میشود. تحریک تخمدان با افزایش تعداد تخمکها و جنینها، نتیجه </span></span><span dir="LTR" style="font-size:10.0pt">IVF</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">را بهبود میبخشد.</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:">هدف این مطالعه مقایسه نتایج تزریق داخل سیتوپلاسمی اسپرم </span></span><span lang="FA" style="font-size:10.0pt">(</span><span dir="LTR" style="font-size:10.0pt">ICSI</span><span lang="FA" style="font-size:10.0pt">)/</span><span dir="LTR" style="font-size:10.0pt">IVF</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در پروتکل تحریک تخمدان دو فازی (</span></span><span dir="LTR" style="font-size:10.0pt">DuoStim</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) با سیکل آنتاگونیست معمول در شرکتکنندگان با </span></span><span dir="LTR" style="font-size:10.0pt">POR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> و با حداقل تزریق 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:">مواد و روش ­ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه کارآزمایی بالینی تصادفی شامل 90 شرکتکننده با پاسخ تخمدانی ضعیف بود که در سال 2025 به کلینیک ناباروری بیمارستان زنان آرش تهران معرفی شده بودند. شرکتکنندگان به طور تصادفی به دو گروه </span></span><span dir="LTR" style="font-size:10.0pt">DuoStim</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> (45 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">n</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و آنتاگونیست معمول (45 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">n</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) تقسیم شدند. پیامدهای این مطالعه عبارتند از تعداد تخمک­های بازیافت­شده و تعداد تخمک­های متافاز </span></span><span dir="LTR" style="font-size:10.0pt">MII</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"></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:">میانگین تعداد تخمکهای 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:"> در گروه </span></span><span dir="LTR" style="font-size:10.0pt">DuoStim</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> برابر با 9/3 </span></span><span lang="FA" style="font-size:10.0pt">±</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 7/5 و در گروه کنترل 9/3 </span></span><span lang="FA" style="font-size:10.0pt">± </span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">2/6 بود (53/0 </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:">). میانگین تعداد کل تخمکهای بازیابی شده در گروه</span></span><span dir="LTR" style="font-size:10.0pt">DuoStim</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 5/4 </span></span><span lang="FA" style="font-size:10.0pt">± </span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">2/7</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">و در گروه کنترل 04/6 </span></span><span lang="FA" style="font-size:10.0pt">±</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 7/9 بود (026/0 </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:">). میانگین تعداد جنینها در گروه </span></span> <span dir="LTR" style="font-size:10.0pt">DuoStim</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 9/3 </span></span><span lang="FA" style="font-size:10.0pt">±</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 5/4 و در گروه کنترل 8/2 </span></span><span lang="FA" style="font-size:10.0pt">±</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 7/4 بود (016/0 </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:">).</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"></span></span></span></span></span></span></span><br>
<b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه­ گیری: </span></span></b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در مطالعه ما، تعداد تخمکهای بازیابی شده و مدت زمان تحریک تخمدان در گروه </span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">DuoStim</span></span> <span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">کمتر از گروه مرسوم بود و ما در مدت زمان کوتاهتری به تعداد تخمکهای مشابه و جنینهای با کیفیت بالا رسیدیم.</span></span></div>
<div style="text-align: justify;"><span style="font-family:Times New Roman;"><span style="font-size:12pt"><span style="line-height:normal"><b><span lang="EN" style="font-size:11.5pt">Background:</span></b><span lang="EN" style="font-size:11.5pt"> In women with poor ovarian response (POR), the quantity and quality of oocytes produced by the ovaries decrease, resulting in poor-quality embryos. Ovarian stimulation, by increasing the number of oocytes and embryos, improves in vitro fertilization (IVF) outcomes. </span></span></span><br>
<span style="font-size:12pt"><span style="line-height:normal"><b><span lang="EN" style="font-size:11.5pt">Objective: </span></b><span lang="EN" style="font-size:11.5pt">The aim of this study was to compare intracytoplasmic sperm injection and IVF outcomes in double stimulation (DuoStim) with a conventional protocol in participants with POR and minimal injection.</span></span></span><br>
<span style="font-size:12pt"><span style="line-height:normal"><b><span lang="EN" style="font-size:11.5pt">Materials and Methods:</span></b><span lang="EN" style="font-size:11.5pt"> This randomized clinical trial was conducted on 90 women with POR referred for IVF treatment at f</span><span lang="EN" style="font-size:11.5pt"><span style="background:white">emale infertility unit, Arash Women's hospital, Tehran University of Medical Sciences, Tehran, Iran</span></span><span lang="EN" style="font-size:11.5pt">. Women were randomly assigned to either the DuoStim group, which underwent ovarian stimulation during both the follicular and luteal phases (n = 45) or the conventional group (n = 45).</span><span lang="EN" style="font-size:11.5pt"> Finally, the number of recovered metaphase II oocytes and the number of oocytes retrieved were measured.</span></span></span><br>
<span style="font-size:12pt"><span style="line-height:normal"><b><span lang="EN" style="font-size:11.5pt">Results:</span></b><span lang="EN" style="font-size:11.5pt"> The mean number of metaphase II eggs was 5.7 ± 3.9 in the DuoStim group and 6.2 ± 3.9 in the conventional group (p = 0.53). The mean total number of retrieved eggs in the DuoStim group was 7.2 ± 4.5, and in the conventional group, it was 9.7 ± 6.04 (p = 0.026). The mean number of embryos obtained in the DuoStim group was 4.5 ± 3.9; in the conventional group, it was 4.7 ± 2.8 (p = 0.016). </span></span></span><br>
<b><span lang="EN" style="font-size:11.5pt"><span style="line-height:115%">Conclusion:</span></span></b><span lang="EN" style="font-size:11.5pt"><span style="line-height:115%"> In our study, the number of oocytes retrieved and the duration of ovarian stimulation were lower in the DuoStim group than the conventional group, and we reached the same number of oocytes and high-quality embryos in a shorter time.</span></span></span></div>
درمان تکمیلی, بازیابی تخمک, تحریک, فولیکول تخمدان, لقاح آزمایشگاهی.
Complementary therapy, Oocyte retrieval, Stimulation, Ovarian follicle, In vitro fertilization.
1021
1030
http://ijrm.ir/browse.php?a_code=A-10-3180-1&slc_lang=en&sid=1
Shahla
Farzipour
shahla.farzipour@gmail.com