IVF-ET后黄体支持作用的评估  

Evaluation of Luteal Support after IVF-ET

作　　者：赵晓明[1] 陈珠萍[1] 洪燕[1] 孙贇[1] 毛宇红[1] 林其德[1] 

机构地区：[1]上海第二医科大学附属仁济医院生殖医学中心,上海200001

出　　处：《生殖与避孕》2005年第7期410-413,共4页Reproduction and Contraception

摘　　要：目的:研究IVF超排卵周期中,胚胎移植(ET)后是否需要黄体支持。方法:随机收集2001.12-2004.12时间本中心的237例23-39岁的不孕症妇女,其中60例自然排卵者为A组,177例采用GnRha长方案降调节超卵排,取卵后,因各种原因未进行移植者35例为B组;胚胎移植后4周B超确认宫内妊娠者随机分为C组(82例,采用短期黄体支持,自移植日起使用黄体酮80mg/d至移植后4周,即孕6周)和D组(60例,采用长期黄体支持,自移植日起使用黄体酮80mg/d至孕12周),比较A、B组妇女的黄体功能状况,C、D组的早期流产率。结果:B组月经来潮时间为取卵后11.5±0.5d,明显短于A组(排卵后13.9±1.4d),P<0.05,有统计学差异。B组黄体晚期(取卵后11d)孕酮水平下降明显,与黄体早期(取卵后2d)相比,比值为0.08±0.01,而A组黄体晚期的孕酮水平呈上升趋势,与黄体早期的比值为1.70±0.27,二组的比值差异非常显著(P<0.01)。C组早期流产率为7.3%,D组为6.7%,二者相比无统计学差异(P>0.05)。结论:①GnRha长方案降调节影响黄体功能。②移植后4周(孕6周)停用黄体酮并不增加流产率。Objective： To study whether luteal support is necessary in IVF program and durition of luteal support. Method： During December 2001 to December 2004, 237 infertility women, aged 25-35 years, randomly collected were involved. Among them, 35 cases were in Group B, who were adopted long-term pituitary downregulation, and super ovarian stimulation but no embryos transferred for some reasons, another 60 women with normal menstrual cycle, as control group（Group A）, were recorded the average days of luteal phase after oocyte retrievals or ovulation and assayed progesterone level in early and late luteal phase in two groups, in order to judging if luteal support was necessary or not after IVF-ET. The other patiens （142 women） who conceived after IVF or ICSI, among them, 82 cases were used progesterone 80 mg for 4 weeks（6 weeks＇ gestion） since embryos transferred named short-term luteal support group（Group C）, anther 60 cases were adopted progesterone 80 mg until 12 weeks＇ gestion named long-term luteal support group（Group D）, compared the miscarrige rate in two groups. Results： The luteal phase was 11.5 ± 0.51 days after oocyte retrievals in Group B, which was shorter than that in Group A （13.93 ± 1.4 days）, there was significant difference between two groups （P〈0.05）. The progesterone level was lower in Group B flaan in Group A （2.4 ± 0.98 ng/ml vs 9.03 ± 3.53 ng/ml, P〈0.01） in late luteal phase. The miscarrige rate was 7.3% in Group C and 6.7% in Group D, there was no statistics difference （P〉 0.05）. Conclusion： ① Luteal support is necessary after IVF-ET. ② Shortening progesterone support doesn＇t increased miscarrige rate, so luteal support is not necessary utill 12 weeks＇ gestion.

关 键 词：GNRHA IVF ICSI 降调节 黄体支持 早孕 流产 

分 类 号：R711.6[医药卫生—妇产科学]