Gynäkologisch-geburtshilfliche Rundschau
Schwerpunkt: In-vitro-Fertilisation
Neue Entwicklungen bei der hormonellen StimulationGriesinger G. · Diedrich K.Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
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Gynäkol Geburtshilfliche Rundsch 2009;49:55–61
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Article / Publication Details
First-Page Preview
Published online: March 25, 2009
Issue release date: March 2009
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 0
ISSN: 1018-8843 (Print)
eISSN: 1423-0011 (Online)
For additional information: https://www.karger.com/GGR
Abstract
Die ovarielle Stimulation ist integraler Bestandteil der In-vitro- Fertilisation (IVF)-Behandlung und trägt wesentlich zur Effizienz des Verfahrens bei. In nicht unerheblichem Ausmass verursacht die ovarielle Stimulation jedoch auch Behandlungsrisiken, Nebenwirkungen sowie finanzielle und psychische Belastungen, sodass eine Weiterentwicklung der gängigen Stimulationsprotokolle notwendig ist. In einer selektiven Literaturübersicht werden ausgewählte, neue Entwicklungen bei der ovariellen Stimulation diskutiert. Zur Prävention eines ovariellen Überstimulationssyndroms im Rahmen der IVF kann humanes Choriongonadotropin durch eine Bolusgabe eines Gonadorelin (GnRH)-Agonisten zur Auslösung der finalen Eizellreifung ersetzt werden. Dieses Vorgehen ist nur im GnRH-Antagonisten-Protokoll möglich und zeigt in mehreren Studien ein sehr gutes Potenzial zur Prävention des ovariellen Hyperstimulationssyndroms bei Risikopatientinnen. Zur Verringerung der Injektionshäufigkeit von Follikel stimulierendem Hormon (FSH) wurde ein lang wirksames FSH-Molekül (carboxyterminales Peptid, FSH-CTP) entwickelt. Phase-III-Daten zeigen, dass FSH-CTP (150 und 100 μg) über mehrere Tage wirkt und ähnlich effektiv und sicher wie die tägliche FSH-Verabreichung im Rahmen der ovariellen Stimulation zur IVF ist. Oral verfügbare Luteinisierungshormon- und FSH-Mimetika werden seit geraumer Zeit entwickelt. Eine Anwendung beim Menschen ist bisher nicht publiziert, und die verfügbaren Erkenntnisse entstammen In-vitro-Versuchen und Tierexperimenten.
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Article / Publication Details
First-Page Preview
Published online: March 25, 2009
Issue release date: March 2009
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 0
ISSN: 1018-8843 (Print)
eISSN: 1423-0011 (Online)
For additional information: https://www.karger.com/GGR
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