medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-3-33-38medsovet-6069Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTКорифоллитропин альфа при различных вариантах овариального ответа в программах вспомогательных репродуктивных технологий: обзор литературыCorifollitropin alfa in different variants of ovarian response in assisted reproductive technology programmes: literature reviewhttps://orcid.org/0000-0002-7150-2230СыркашеваА. Г.SyrkashevaA. G.

Сыркашева Анастасия Григорьевна - кандидат медицинских наук, старший научный сотрудник отделения вспомогательных технологий в лечении бесплодия имени профессора Б.В. Леонова/

117485, Москва, ул. Академика Опарина, д. 4

Anastasiya G. Syrkasheva - Cand. Sci. (Med.), Senior Researcher of the Department of Assisted Reproductive Technologies in Infertility Treatment named after Professor B.V. Leonov/

4, Academician Oparin St., Moscow, 117997

anast.syrkasheva@gmail.comhttps://orcid.org/0000-0002-8558-4687ЕрмаковаД. М.ErmakovaD. M.

Ермакова Дарья Михайловна - аспирант отделения вспомогательных технологий в лечении бесплодия имени профессора Б.В. Леонова/

117485, Москва, ул. Академика Опарина, д. 4

Daria M. Ermakova - Postgraduate Student of the Department of Assisted Reproductive Technologies in Infertility Treatment named after Professor B.V. Leonov/

4, Academician Oparin St., Moscow, 117997

daria.ermakova.2021@gmail.comНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика B.И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian Federation202114042021033338Copyright © Сыркашева А.Г., Ермакова Д.М., 20212021Сыркашева А.Г., Ермакова Д.М.Syrkasheva A.G., Ermakova D.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6069

Обзор литературы посвящен применению корифоллитропина альфа для стимуляции яичников в программах вспомогательных репродуктивных технологий (ВРТ) у различных групп пациенток. Корифоллитропин альфа - это препарат гонадотропинов, имеющий пролонгированную ФСГ-активность. Основное отличие корифоллитропина альфа от других гонадотропинов - более высокий уровень пикового ФСГ, что приводит к рекрутингу большего числа фолликулов. Другой особенностью является невозможность коррекции дозы гонадотропинов в течение первых дней стимуляции яичников. В отличие от традиционных показа-ний/противопоказаний к гонадотропинам, использование корифоллитропина не рекомендовано в сочетании с агонистами ГнРГ, а также у пациенток с синдромом поликистозных яичников.

Проведен анализ данных целесообразности и эффективности использования корифоллитропина альфа у пациенток с различными вариантами овариального ответа в программах ВРТ. Большинство исследователей сходятся во мнении, что использование корифоллитропина альфа может быть рекомендовано для пациенток с предполагаемым бедным или нормальным ответом яичников. Использование корифоллитропина альфа у пациенток с предполагаемым избыточным ответом на стимуляцию яичников возможно в тех случаях, когда не предполагается перенос эмбриона: в циклах донации ооцитов/витрификации собственных ооцитов или в циклах «freeze-all».

Значимым преимуществом использования корифоллитропина альфа для пациенток - доноров ооцитов является однократное введение препарата, которое можно осуществить в медицинской организации, что снижает риск несоблюдения назначений. Использование корифоллитропина альфа в протоколах с агонистами ГнРГ требует проведения дальнейших исследований: во-первых, корифоллитропин альфа не имеет ЛГ-компонента, во-вторых, в данном протоколе нет возможности провести замену триггера овуляции при высоком риске ранней формы синдрома гиперстимуляции яичников.

This literature review focuses on the use of corifollitropin alfa for ovarian stimulation in assisted reproductive technology (ART) programmes in different groups of patients. Corifollitropin alfa is a gonadotropin drug with prolonged FSH activity. The main difference between corifollitropin alfa and other gonadotropins is the higher level of peak FSH, which leads to the recruitment of more follicles. Another feature is the inability to adjust the gonadotropin dose during the first days of ovarian stimulation. In contrast to traditional indications/contraindications for gonadotropins, the use of cortifollitropin is not recommended in combination with GnRH agonists or in patients with polycystic ovary syndrome.

Evidence for the feasibility and efficacy of using corifollitropin alfa in patients with various ovarian response variants in ART programmes has been analysed. Most researchers agree that the use of corifollitropin alfa can be recommended for patients with a presumed poor or normal ovarian response. The use of corifollitropin alfa in patients with a presumed excessive response to ovarian timulation is possible when embryo transfer is not expected: in oocyte donation/oocyte vitrification cycles or in "freeze-all" cycles.

A significant advantage of using corifollitropin alfa for oocyte donor patients is the single administration of the drug, which can be done in a medical facility, which reduces the risk of prescription non-compliance.

The use of corifollitropin alfa in protocols with GnRH agonists requires further research: firstly, corifollitropin alfa has no LH component and secondly, there is no possibility of ovulation trigger replacement in this protocol if there is a high risk of early ovarian hyperstimulation syndrome.

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The authors declare that there are no conflicts of interest present.