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辅助生殖中的糖皮质激素治疗。

Glucocorticoid therapy in assisted reproduction.

作者信息

Kim Yong Jin

机构信息

Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.

出版信息

Clin Exp Reprod Med. 2021 Dec;48(4):295-302. doi: 10.5653/cerm.2021.04819. Epub 2021 Nov 30.

Abstract

As glucocorticoids are well-known as important regulators of stress and the immune system, their function and clinical use have elicited substantial interest in the field of reproduction. In particular, the effect of glucocorticoid therapy on endometrial receptivity during assisted reproduction, including in vitro fertilization (IVF) cycles, has led to a great deal of interest and controversy. However, previous studies have not been able to provide consistent and reliable evidence due to their small, non-controlled designs and use of different criteria. Considering the potential risk of exposure to glucocorticoids for mothers and fetuses in early pregnancy, the use of glucocorticoids in IVF cycles should be carefully evaluated, including the balance between risk and benefit. To date, there is no conclusive evidence that the use of glucocorticoids improves the pregnancy rate in IVF cycles with unselected subjects, and a further investigation should be considered with a proper study design.

摘要

由于糖皮质激素作为应激和免疫系统的重要调节因子广为人知,其功能和临床应用在生殖领域引起了极大的关注。特别是,糖皮质激素治疗对辅助生殖过程中子宫内膜容受性的影响,包括体外受精(IVF)周期,引发了大量的关注和争议。然而,由于以往研究规模小、缺乏对照设计且使用不同标准,未能提供一致且可靠的证据。考虑到孕早期母亲和胎儿接触糖皮质激素的潜在风险,应仔细评估IVF周期中糖皮质激素的使用,包括风险与益处的平衡。迄今为止,尚无确凿证据表明在未经过筛选的受试者的IVF周期中使用糖皮质激素可提高妊娠率,因此应考虑采用适当的研究设计进行进一步调查。

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