Место протоколов с антагонистами гонадотропин-рилизинг-гормона в современных программах вспомогательных репродуктивных технологий: возможности использования нового препарата ганиреликса

Закрыть метаданные

Рекомендуем статьи по данной теме:

Вспомогательные репродуктивные технологии и риск приращения плаценты. Проблемы репродукции. 2024;(3):43-49

Кальций-фосфорный обмен и вспомогательные репродуктивные технологии: точки пересечения. Проблемы репродукции. 2024;(4):19-28

Эндометриоидные кисты и бесплодие: дилемма при выборе тактики (обзор литературы). Проблемы репродукции. 2024;(4):29-37

Нормативное регулирование применения гестагенов в России в эру индивидуализированного подхода к поддержке лютеиновой фазы в программах вспомогательных репродуктивных технологий. Проблемы репродукции. 2024;(4):59-70

Корреляционная зависимость уровней тканевого ингибитора металлопротеиназы-1 и особенностей морфологии фолликулярной жидкости у пациенток с сочетанным (миома матки и эндометриоз) бесплодием в программах ВРТ. Российский вестник акушера-гинеколога. 2024;(4):21-28

Дискуссионные вопросы адъювантной терапии после миомэктомии. Российский вестник акушера-гинеколога. 2024;(5):101-107

Сравнительный анализ качества ооцитов у пациенток с трубно-перитонеальным генезом бесплодия в программах вспомогательных репродуктивных технологий. Российский вестник акушера-гинеколога. 2024;(6):41-49

Опыт применения назальной формы агонистов ГнРГ в программах экстракорпорального оплодотворения. Российский вестник акушера-гинеколога. 2024;(6):79-84

Возможности прогнозирования и снижения риска развития рака молочной железы у женщин на фоне применения вспомогательных репродуктивных технологий. Российский вестник акушера-гинеколога. 2025;(1):59-64

Овариальная стимуляция является важнейшим этапом ряда программ вспомогательных репродуктивных технологий (ВРТ), поскольку позволяет получить большую когорту ооцитов в одном менструальном цикле, размер которой напрямую коррелирует с количеством полученных эмбрионов. Одним из приоритетных направлений в репродуктивной медицине является дифференцированный подход к подбору наиболее подходящего протокола стимуляции яичников с учетом возраста пациентки, овариального резерва, наличия сопутствующей генитальной и экстрагенитальной патологии, определяющих прогнозируемый ответ яичников на стимуляцию, с целью получения адекватного количества ооцитов и эмбрионов и снижения риска возможных осложнений. Тенденция к снижению продолжительности овариальной стимуляции, уменьшению медикаментозной нагрузки и, соответственно, стоимости проводимой терапии тесно ассоциирована с повышением удовлетворенности пациенток. Несмотря на то, что долгие годы в качестве «золотого стандарта» лечения бесплодия выступал «длинный» протокол стимуляции с агонистами гонадотропин-рилизинг-гормона, в последние годы в большинстве циклов используются протоколы с антагонистами гонадотропин-рилизинг-гормона. Данный обзор посвящен особенностям использования антагонистов гонадотропин-рилизинг-гормона, в частности ганиреликса, в программах ВРТ, роли этого препарата как в стимулированных циклах, так и в циклах подготовки к переносу размороженного эмбриона.

Ключевые слова:

вспомогательные репродуктивные технологии

агонисты гонадотропин-рилизинг-гормона

антагонисты гонадотропин-рилизинг-гормона

ганиреликс

Авторы:

Денисова Ю.В.

ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России

ORCID: 0000-0003-1753-0537

Колода Ю.А.

ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России;
ООО «Центр репродукции «Линия жизни»

ORCID: 0000-0003-2502-575X

Дата поступления:

15.05.2024

Дата принятия в печать:

06.06.2024

Список литературы:

Esteves SC, Khastgir G, Shah J, Murdia K, Gupta SM, Rao DG, Dash S, Ingale K, Patil M, Moideen K, Thakor P, Dewda P. Association between progesterone elevation on the day of human chronic gonadotropin trigger and pregnancy outcomes after fresh embryo transfer in in vitro fertilization/intracytoplasmic sperm injection cycles. Frontiers in Endocrinology. 2018;9:201. https://doi.org/10.3389/fendo.2018.00201
Bosch E, Valencia I, Escudero E, Crespo J, Simón C, Remohí J, Pellicer A. Premature luteinization during gonadotropin-releasing hormone antagonist cycles and its relationship with in vitro fertilization outcome. Fertility and Sterility. 2003;80(6):1444-1449. https://doi.org/10.1016/j.fertnstert.2003.07.002
Lawrenz B, Fatemi HM. Effect of progesterone elevation in follicular phase of IVF-cycles on the endometrial receptivity. Reproductive BioMedicine Online. 2017;34(4):422-428. https://doi.org/10.1016/j.rbmo.2017.01.011
Назаренко Т.А. Стимуляция функции яичников. М.: МЕДпресс-информ; 2008.
Митюрина Е.В., Перминова С.Г., Демура Т.А., Галлямова Е.В. Морфофункциональное состояние эндометрия в стимулированных циклах программы экстракорпорального оплодотворения. Акушерство и гинекология. 2014;11:80-87.
Kim KY, Choi KC, Auersperg N, Leung PCK. Mechanism of gonadotropin-releasing hormone (GnRH)-I and -II-induced cell growth inhibition in ovarian cancer cells: Role of the GnRH-I receptor and protein kinase C pathway. Endocrine-Related Cancer. 2006;13:211-220.
Di Spiezio Sardo A, Ciccarone F, Muzii L, Scambia G, Vignali M. Use of oral GnRH antagonists combined therapy in the management of symptomatic uterine fibroids. Facts, Views and Vision in ObGyn. 2023;15(1):29-33. https://doi.org/10.52054/FVVO.15.1.059
Elzaher MA, Moawad A, Madkour WA, Ali M, Salah Eldin Abdel Hamid AM, Zaheer H. Does medical debulking with gonadotrophin-releasing hormone agonist facilitate vaginal hysterectomy with a moderate enlarged uterus? A randomized control study. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2013;169(2):326-330. https://doi.org/10.1016/j.ejogrb.2013.03.007
Matsuo H, Baba Y, Nair RM, Arimura A, Schally AV. Structure of the porcine LH- and FSH-releasing hormone. I. The proposed amino acid sequence. Biochemical and Biophysical Research Communications. 1971;43(6):1334-1339.
Hall JE, Brodie TD, Badger TM, et al. Evidence of differential control of FSH and LH secretion by gonadotropin-releasing hormone (GnRH) from the use of a GnRH antagonist. The Journal of Clinical Endocrinology and Metabolism. 1988;67:524-531.
Deghenghi R, Antarelix TM. In: Filicori M, Flamigni C, eds. Treatment with GnRH Analogs: Controversies and Perspectives. Carnforth: Parthenon Publishing; 1996;89-91.
Al-Inany HG, Abou-Setta AM, Aboulghar M. Gonadotrophinreleasing hormone antagonists for assisted conception: a Cochrane review. Reproductive BioMedicine Online. 2007;14:5:640-649.
Toftager M, Bogstad J, Løssl K, Prætorius L, Zedeler A, Bryndorf T, Nilas L, Pinborg A. Cumulative live birth rates after one ART cycle including all subsequent frozen—thaw cycles in 1050 women: secondary outcome of an RCT comparing GnRH-antagonist and GnRH-agonist protocols. Human Reproduction. 2017;32(3):556-567. https://doi.org/10.1093/humrep/dew358
Bosch E, Longobardi S, D’Hooghe T, Humaidan P. Time to pregnancy and birth during fertility treatment — a Delphi Consensus. ESHRE 2017 Switzerland. Accessed June 14, 2024. https://hcp.merckgroup.com/neast-en/fertility/science-hub/online-library/talking-publications/bosch.html
Palomba S, Costanzi F, Nelson SM, Caserta D, Humaidan P. Interventions to prevent or reduce the incidence and severity of ovarian hyperstimulation syndrome: a systematic umbrella review of the best clinical evidence. Reproductive Biology and Endocrinology. 2023;21(1):67. https://doi.org/10.1186/s12958-023-01113-6
Tarlatzis BC, Fauser BC, Kolibianakis EM, Diedrich K, Rombauts L, Devroey P. GnRH antagonists in ovarian stimulation for IVF. Human Reproduction Update. 2006;12(4):333-340. https://doi.org/10.1093/humupd/dml001
Olivennes F, Belaisch-Allart J, Emperaire JC, Dechaud H, Alvarez S, Moreau L, Nicollet B, Zorn JR, Bouchard P, Frydman R. Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin). Fertility and Sterility. 2000;73(2):314-320. https://doi.org/10.1016/s0015-0282(99)00524-5
Wilcox J, Potter D, Moore M, Ferrande L, Kelly E; CAP IV Investigator Group. Prospective, randomized trial comparing cetrorelix acetate and ganirelix acetate in a programmed, flexible protocol for premature luteinizing hormone surge prevention in assisted reproductive technologies. Fertility and Sterility. 2005;84(1):108-117. https://doi.org/10.1016/j.fertnstert.2005.03.016
Ludwig M, Katalinic A, Banz C, Schröder AK, Löning M, Weiss J.M, Diedrich K. Tailoring the GnRH antagonist cetrorelix acetate to individual patients’ needs in ovarian stimulation for IVF. Human Reproduction. 2002;17(11):2842-2845. https://doi.org/10.1093/humrep/17.11.2842
Olivennes F, Diedrich K, Frydman R, Felberbaum RE, Howles CM; Cerotide Multiple Dose International Study Group; Cetrotide Single Dose International Study Group. Safety and efficacy of a 3 mg dose of the GnRH antagonist cetrorelix in preventing premature LH surges. Reproductive BioMedicine Online. 2003;6(4):432-438. https://doi.org/10.1016/s1472-6483(10)62163-3
Al-Inany HG, Aboulghar M, Mansour R, Serour GI. Optimizing GnRH antagonist administration: metaanalysis of fixed vs flexible protocol. Reproductive BioMedicine Online. 2005;10:567.
Association, ECCGoRMCoCMWs. Expert consensus on standardized application of antagonist protocol in assisted reproductive technology. Chinese Journal of Reproductive Contraception. 2022;(2):109-116. https://doi.org/10.3760/cma.j.cn101441-20211108-00495
Neykova K, Tosto V, Giardina I, Tsibizova V, Vakrilov G. Endometrial receptivity and pregnancy outcome. Journal of Maternal-Fetal and Neonatal Medicine. 2022;35(13):2591-605. https://doi.org/10.1080/14767058.2020.1787977
Xie Q, Ni D, Chen S, Zhang W, Wang J, Ling X, Shen R. Meta-analysis of trigger timing in normal responders undergoing GnRH antagonist ovarian hyperstimulation protocol. Journal of Ovarian Research. 2024;17(1):56. https://doi.org/10.1186/s13048-024-01379-3
Humaidan P, Quartarolo J, Papanikolaou EG. Preventing ovarian hyperstimulation syndrome: guidance for the clinician. Fertility and Sterility. 2010;94(2):389-400. https://doi.org/10.1016/j.fertnstert.2010.03.028
Al-Inany HG, Youssef MA, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, Abou-Setta AM. Gonadotrophin-releasing hormone antagonists for assisted reproductive technology. The Cochrane Database of Systematic Reviews. 2011;(5):CD001750. https://doi.org/10.1002/14651858.CD001750.pub3
Papanikolaou EG, Pozzobon C, Kolibianakis EM, Camus M, Tournaye H, Fatemi HM, Van Steirteghem A, Devroey P. Incidence and prediction of ovarian hyperstimulation syndrome in women undergoing gonadotropin-releasing hormone antagonist in vitro fertilization cycles. Fertility and Sterility. 2006;85(1):112-120. https://doi.org/10.1016/j.fertnstert.2005.07.1292
Sharif K, Coomarasamy A, eds. Assisted reproduction Techniques: Challenges and Management Options. Wiley-Blackwell; 2012. Accessed June 14, 2024. https://www.wiley.com/en-us/Assisted+Reproduction+Techniques%3A+Challenges+and+Management+Options-p-9781444335552
Papanikolaou EG, Tournaye H, Verpoest W, Camus M, Vernaeve V, Van Steirteghem A, Devroey P. Early and late ovarian hyperstimulation syndrome: early pregnancy outcome and profile. Human Reproduction. 2005;20(3):636-641. https://doi.org/10.1093/humrep/deh638
Xiao J, Su C, Zeng X. Comparisons of GnRH antagonist versus GnRH agonist protocol in supposed normal ovarian responders undergoing IVF: a systematic review and meta-analysis. PLoS One. 2014;9(9):e106854. https://doi.org/10.1371/journal.pone.0106854
Gustofson RL, Larsen FW, Bush MR, Segars JH. Treatment with gonadotropin-releasing hormone (GnRH) antagonists in women suppressed with GnRH agonist may avoid cycle cancellation in patients at risk for ovarian hyperstimulation syndrome. Fertility and Sterility. 2006;85(1):251-254. https://doi.org/10.1016/j.fertnstert.2005.07.1291
Kol S. Luteolysis induced by a gonadotropin-releasing hormone agonist is the key to prevention of ovarian hyperstimulation syndrome. Fertility and Sterility. 2004;81(1):1-5. https://doi.org/10.1016/j.fertnstert.2003.05.032
Itskovitz J, Boldes R, Barlev A, Erlik Y, Kahana L, Brandes JM. The induction of LH surge and oocyte maturation by GnRH analogue (buserelin) in women undergoing ovarian stimulation for in vitro fertilisation. Gynecolgical Endocrinology. 1988;2(suppl 2):165.
Babayof R, Margalioth EJ, Huleihel M, Amash A, Zylber-Haran E, Gal M, Brooks B, Mimoni T, Eldar-Geva T.Serum inhibin A, VEGF and TNFalpha levels after triggering oocyte maturation with GnRH agonist compared with HCG in women with polycystic ovaries undergoing IVF treatment: a prospective randomized trial. Human Reproduction. 2006;21(5):1260-1265. https://doi.org/10.1093/humrep/dei475
Engmann L, DiLuigi A, Schmidt D, Nulsen J, Maier D, Benadiva C. The use of gonadotropin-releasing hormone (GnRH) agonist to induce oocyte maturation after cotreatment with GnRH antagonist in high-risk patients undergoing in vitro fertilization prevents the risk of ovarian hyperstimulation syndrome: a prospective randomized controlled study. Fertility and Sterility. 2008;89(1):84-91. https://doi.org/10.1016/j.fertnstert.2007.02.002
Griesinger G, von Otte S, Schroer A, Ludwig AK, Diedrich K, Al-Hasani S, Schultze-Mosgau A. Elective cryopreservation of all pronuclear oocytes after GnRH agonist triggering of final oocyte maturation in patients at risk of developing OHSS: a prospective, observational proof-of-concept study. Human Reproduction. 2007;22(5):1348-1352. https://doi.org/10.1093/humrep/dem006
Manzanares MA, Go´mez-Palomares JL, Ricciarelli E, Herna´ndez ER. Triggering ovulation with gonadotropin-releasing hormone agonist in in vitro fertilization patients with polycystic ovaries does not cause ovarian hyperstimulation syndrome despite very high estradiol levels. Fertility and Sterility. 2010;93(4):1215-1219. https://doi.org/10.1016/j.fertnstert.2008.12.019
D’Angelo A, Brown J, Amso NN. Coasting (withholding gonadotrophins) for preventing ovarian hyperstimulation syndrome. The Cochrane Database of Systematic Reviews. 2011;(6):CD002811. https://doi.org/10.1002/14651858.CD002811.pub3
Youssef MA, Van der Veen F, Al-Inany HG, Griesinger G, Mochtar MH, Aboulfoutouh I, Khattab SM, van Wely M. Gonadotropin-releasing hormone agonist versus HCG for oocyte triggering in antagonist assisted reproductive technology cycles. The Cochrane Database of Systematic Reviews. 2011;(1):CD008046. https://doi.org/10.1002/14651858.CD008046.pub3
Kuan KKW, Omoseni S, Tello JA. Comparing ART outcomes in women with endometriosis after GnRH agonist versus GnRH antagonist ovarian stimulation: a systematic review. Therapeutic Advances in Endocrinology and Metabolism. 2023;14:20420188231173325. https://doi.org/10.1177/20420188231173325
Liu C, Tian T, Lou Y, Li J, Liu P, Li R, Qiao J, Wang Y, Yang R. Live birth rate of gonadotropin-releasing hormone antagonist versus luteal phase gonadotropin-releasing hormone agonist protocol in IVF/ICSI: a systematic review and meta-analysis. Expert Reviews in Molecular Medicine. 2023;26:e2. https://doi.org/10.1017/erm.2023.25
Kolibianakis EM, Tarlatzis BC, Devroey P. GnRH antagonists in IVF. Reproductive BioMedicine Online. 2005;10(6):705-712. https://doi.org/10.1016/s1472-6483(10)61113-3
Lee TH, Liu CH, Huang CC, Wu YL, Shih YT, Ho HN, Yang YS, Lee MS. Serum anti-M -Müllerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles. Human Reproduction. 2008;23(1):160-167. https://doi.org/10.1093/humrep/dem254
Kwee J, Schats R, McDonnell J, Themmen A, de Jong F, Lambalk C. Evaluation of anti-Müllerian hormone as a test for the prediction of ovarian reserve. Fertility and Sterility. 2008;90(3):737-743. https://doi.org/10.1016/j.fertnstert.2007.07.1293
DiLuigi AJ, Engmann L, Schmidt DW, Maier DB, Nulsen JC, Benadiva CA. Gonadotropin-releasing hormone agonist to induce final oocyte maturation prevents the development of ovarian hyperstimulation syndrome in high-risk patients and leads to improved clinical outcomes compared with coasting. Fertility and Sterility. 2010;94(3):1111-1114. https://doi.org/10.1016/j.fertnstert.2009.10.034
Kwee J, Elting ME, Schats R, McDonnell J, Lambalk CB. Ovarian volume and antral follicle count for the prediction of low and hyper responders with in vitro fertilization. Reproductive Biology and Endocrinology. 2007;5:9. https://doi.org/10.1186/1477-7827-5-9
Синдром гиперстимуляции яичников. Клинические рекомендации. 2021. Одобрено Научно-практическим Советом Министерства здравоохранения Российской Федерации. Ссылка активна на 14.06.24 https://cr.minzdrav.gov.ru/recomend/665_1?ysclid=lxpsxh0l2a11454240
Farquhar C, Rombauts L, Kremer JA, Lethaby A, Ayeleke RO. Oral contraceptive pill, progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive. The Cochrane Database of Systematic Reviews. 2017;5(5):CD006109. https://doi.org/10.1002/14651858.CD006109.pub3
Blockeel C, Baumgarten M, De Vos M, Verheyen G, Devroey P. Administration of GnRH antagonists in case of elevated progesterone at initiation of the cycle: a prospective cohort study. Current Pharmaceutical Biotechnology. 2010;12(3):423-428. https://doi.org/10.2174/138920111794480633
Cakmak H, Tran N, Zamah M, Cedars M, Rosen M. A novel «delayed start» protocol with gonadotropin-releasing hormone antagonist improves outcomes in poor responders. Fertility and Sterilit.. 2014;101(5):1308-1314. https://doi.org/10.1016/j.fertnstert.2014.01.050
Blockeel C, Riva A, De Vos M, Haentjens P, Devroey P. Administration of a gonadotropin-releasing hormone antagonist during the 3 days before the initiation of the in vitro fertilization/intracytoplasmic sperm injection treatment cycle: impact on ovarian stimulation. A pilot study. Fertility and Sterility. 2011;95(5):1714-1719. https://doi.org/10.1016/j.fertnstert.2011.01.028
Huirne JA, van Loenn AC, Schats R, McDonnell J, Hompes PG, Schoemaker J, Homburg R, Lambalk CB. Dose-finding study of daily GnRH antagonist for the prevention of premature LH surges in IVF/ICSI patients: optimal changes in LH and progesterone for clinical pregnancy. Human Reproduction. 2005;20(2):359-367. https://doi.org/10.1093/humrep/deh601
Younis J, Soltsman S, Izhaki I, Radin O, Radin O, Bar-Ami S, Ben-Ami M. Early and short follicular Gonadotropin-releasing hormone antagonist supplementation improves the meiotic status and competence of retrieved oocytes in In vitro fertilization-embryo transfer cycles. Fertility and Sterility. 2010;94(4):1350-1355. https://doi.org/10.1016/j.fertnstert.2009.08.033
Al-Obaidi M. Effect of early GnRH antagonist administration on assisted reproductive technique outcomes in normal responders. Journal of Medicine and Life. 2022;15(2):258-263. https://doi.org/10.25122/jml-2021-0286
Xia L, Tian L, Zhang S, Huang J and Wu Q. Hormonal Replacement Treatment for Frozen-Thawed Embryo Transfer With or Without GnRH Agonist Pretreatment: A Retrospective Cohort Study Stratified by Times of Embryo Implantation Failures. Frontiers in Endocrinology. 2022;13:803471. https://doi.org/10.3389/fendo.2022.803471
Денисова В.М., Исакова Э.В., Близнюкова Н.С., Корсак В.С. Эффективность подготовки эндометрия к переносу размороженных эмбрионов с применением антагониста гонадотропин-рилизинг-гормона. Проблемы репродукции. 2020;26(2):41-46. https://doi.org/10.17116/repro20202602141
Venetis CA, Storr A, Chua SJ, Mol BW, Longobardi S, Yin X, D’Hooghe T. What is the optimal GnRH antagonist protocol for ovarian stimulation during ART treatment? A systematic review and network meta-analysis. Human Reproductionuction Update. 2023;29(3):307-326. https://doi.org/10.1093/humupd/dmac040
European Medicines Agency. Ganirelix Gedeon Richter EPAR. EMA/588110/2022. May 2022. Accessed June 14, 2024. https://www.ema.europa.eu/en/documents/assessment-report/ganirelix-gedeon-richter-epar-public-assessment-report_en.pdf.AccessedOctober2022
Borm G, Mannaerts B. The European Orgalutran study group. Treatment with the gonadotropin-releasing hormone antagonist ganirelix in women undergoing controlled ovarian hyperstimulation with recombinant follicle stimulating hormone is effective, safe and convenient: results of a controlled, randomized, multicentre trial. Human Reproduction. 2000;15(7):1490-1498. https://doi.org/10.1093/humrep/15.7.1490
Fluker M, Grifo J, Leader A, Levy M, Meldrum D, Muasher SJ, Rinehart J, Rosenwaks Z, Scott RT Jr, Schoolcraft W, Shapiro DB; North American Ganirelix Study Group. Efficacy and safety of ganirelix acetate versus leuprolide acetate in women undergoing controlled ovarian hyperstimulation. Fertility and Sterility. 2001;75(1):38-45. https://doi.org/10.1016/s0015-0282(00)01638-1
The European and Middle East Orgalutran Study Group. Comparable clinical outcome using the GnRH antagonist ganirelix or a long protocol of the GnRH agonist triptorelin for the prevention of premature LH surges in women undergoing ovarian stimulation. Human Reproduction. 2001;16(4):644-651. https://doi.org/10.1093/humrep/16.4.644
The ganirelix dose-finding study group. A double-blind, randomized, dose-finding study to assess the efficacy of the GnRH antagonist ganirelix (Org 37642) to prevent premature LH surges in women undergoing controlled ovarian hyperstimulation with recombinant FSH (Puregon). Human Reproduction. 1998;13(11):3023-3031.
Itskovitz-Eldor J, Kol S, Mannaerts B, Coelingh Bennink HC. First established pregnancy after controlled ovarian hyperstimulation with recombinant follicle stimulating hormone and the gonadotropin-releasing hormone antagonist ganirelix (Org 37642). Human Reproduction. 1998;13(2):294-295. https://doi.org/10.1093/humrep/13.2.294
De Jong D, Macklon NS, Mannaerts B, Coelingh Bennink HJ, Fauser BC. High-dose gonadotropin-releasing hormone antagonist (ganirelix) may prevent ovarian hyperstimulation syndrome caused by ovarian stimulation for in vivo fertilization. Human Reproduction. 1998;13(3):573-575. https://doi.org/10.1093/humrep/13.3.573
Parisi CAS, Kelly KJ, Ansotegui IJ, Gonzalez-Díaz SN, Bilò MB, Cardona V, Park HS, Braschi MC, Macias-Weinmann A, Piga MA, Acuña-Ortega N, Sánchez-Borges M, Yañez A. Update on latex allergy: New insights into an old problem. World Allergy Organization Journal. 2021;14(8):100569. https://doi.org/10.1016/j.waojou.2021.100569

Закрыть метаданные