晚卵泡期及黄体早期血清雌激素比值与体外受精结局的关系  

The Relationship between the Ratio of Estradiol Concentration of Late-follicular Phase to Earlier Period of Luteum and In-vitro Fertilization Outcome

作　　者：刘蓓[1] 章晓梅[2] 李永刚[2] 冯怀英[2] 邓波[2] 

机构地区：[1]中国人民解放军昆明总医院妇产科 [2]云南省第一人民医院生殖遗传科,云南昆明650032

出　　处：《昆明医学院学报》2007年第1期59-62,70,共5页Journal of Kunming Medical College

摘　　要：目的探讨控制性促排卵(COH)周期中晚卵泡期及黄体早期雌激素比值与体外受精-胚胎移植(IVF-ET)结局的关系.方法194例因输卵管因素不孕的患者行COH,注射人绒毛膜促性腺激素(hCG)日及ET日测定血清雌激素水平,依其比值分为3组:组1:hCG日E2(雌二醇)/ET日E2<2.0;组2:比值介于2.0-4.0之间;组3:比值>4.0.结果COH后共有67例妊娠(34.5%),妊娠组与非妊娠组及不同E2比值的三组间比较,患者年龄、hCG日E2水平、获卵数、受精率、ET日E2水平均无显著差异,但当hCG日E2与ET日E2比值>4.0时,妊娠率显著降低.结论在IVF周期中,hCG日至ET日E2值迅速下降幅度可预测妊娠结局,推测雌激素水平迅速下降可能损害子宫内膜的容受性,黄体期适当补充雌激素将有利于妊娠结局.Objective To study the effects of the relationship between the ratio of serum estradiol （ E2 ） of late -follicular phase to earlier period of luteum and in - vitro fertilization outcome on pregnancy during controlled ovarian hyperstimulation （COH）. Methods 194 infertility patients underwent COH because of uterine tube and their serum estradiol were measured on the day of hCG administration （ day - of - hCG） and the day of embryo transfer （ day - of - ET）. They were divided into three groups according to the ratio of day - of - hCG es- tradiol to day - of - ET estradiol ： group one （ r 〈 2. 0 ）, group two （ 2. 0 - 4. 0 ）, and group three （ r 〉 4. 0 ）. Results 67 pregnancies were noted （34. 5 % ）. There were no significant differences in age, the level of day - of - hCG estradiol, the number of retrieved oocytes, the fertilization rates and the level of day - of - ET estradiol between pregnant and non - pregnant women and among the three groups. However, when the ratio of day - of - hCG estradiol to day - of - ET estradiol was more than 4. 0, the clinical pregnancy rate was significantly lower. Conclusion It is suggested that in IVF cycle, the rapid decline of the ratio of day - of - hCG estradiol to day -of- ET estradiol is important in predicting IVF success. We presumed that a dramatic drop in estradiol level may damage the endometrial receptivity, and the proper supplementation of estradiol during luteal phase might be beneficial to improve some women＇ s pregnant outcome.

关 键 词：促超排卵 雌激素 黄体期 妊娠率 

分 类 号：R711.6[医药卫生—妇产科学]