控制性卵巢刺激中HCG注射后雌二醇浓度下降的原因分析  

Analysis of Decreased Serum Estradiol Level after Human Chorionic Gonadotropin Administration during Controlled Ovarian Hyperstimulation

作　　者：梁晓燕[1] 马文红[1] 杨刚[2] 

机构地区：[1]中山大学附属第六医院生殖中心,广东广州510655 [2]中山大学附属第一医院妇产科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2010年第4期530-534,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(30973202);广东省自然科学基金(07117364);广东省教育部学研综合项目(2008B090500194)

摘　　要：【目的】探讨控制性超排卵(COH)过程中HCG注射后雌二醇(E2)及其它激素浓度的变化,并分析对妊娠结局的影响。【方法】前瞻性研究74例行COH的不孕患者,采外周静脉血检测患者基础性激素水平、启动日卵泡刺激素(FSH)、黄体生成素(LH)和E2以及HCG注射日、采卵(OPU)日、移植(ET)日的LH、E2和孕酮(P)浓度。根据妊娠结局分为妊娠组(n=28)与非妊娠组(n=46)。【结果】74例患者HCG注射日、OPU日和ET日的E2[(2380±1177vs.839±446vs.1199±634)pg/mL,P<0.01]、P[(0.50±0.29vs.7±4vs.84±48)ng/mL,P<0.01]浓度差异有统计学意义。获卵数与HCG日(r=0.602,P<0.01)、OPU日(r=0.545,P<0.01)E2浓度呈正相关。妊娠组与非妊娠组的年龄﹑基础性激素水平﹑获卵数﹑受精数﹑移植胚胎数以及HCG注射日﹑OPU日和ET日的LH﹑E2和P的差异均无统计学意义(P>0.05)。妊娠组HCG日、OPU日和ET日的E2[(2400±1116vs.909±492vs.1263±662)pg/mL,P<0.01]、P[(0.5±0.4vs.6±3vs.79±38)ng/mL,P<0.01]浓度差异均有统计学意义。非妊娠组HCG日、OPU日和ET日的E2[(2369±1225vs.797±466vs.1161±621)pg/mL,P<0.01]、P[(0.52±0.28vs7±4vs87±51)ng/mL,P<0.01]之间浓度差异同样均有统计学意义。【结论】COH中,E2浓度在HCG注射后显著下降,采卵日E2浓度明显低于HCG日及ET日(P<0.01),采卵后开始上升;E2浓度的下降对妊娠结局无明显影响。【Objective】 To evaluate the impact of serum estradiol （E2） and other hormone levels after human chorionic gonadotropin （HCG） administration on IVF-ET outcome during controlled ovarian hyperstimulation （COH）. 【Methods】 In this prospective study,blood samples were collected from a total of 76 women with sterility undergoing COH for IVF-ET to assay the hormones on the day of ovarian stimulation initiation,HCG administration,ovum picking-up （OPU） and embryo transferring （ET）. Patients were divided into two groups：pregnant group （n = 28） and non-pregnant group （n = 46）. 【Results】 The E2 [（2 380 ± 1 177 vs. 839 ± 446 vs. 1 199 ± 634） pg / mL,P〈 0.01],progesterone （P） [（0.50 ± 0.29 vs. 7 ± 4 vs. 84 ± 48） ng / mL,P 〈0.01] levels on the day of HCG administration,OPU and ET were significantly different in the 74 patients. The number of oocytes retrieved were positively correlated with the E2 levels at the day of HCG administration （r = 0.602,P 〈0.01）,OPU （r = 0.545,P 〈0.01）. No significant differences were found between the pregnant （n = 28） and non-pregnant （n = 46） groups with regard to the ages,baseline hormones,number of oocytes retrieved,fertilized,embryo transferred and LH,E2,P levels on the day of HCG administration,OPU and ET. The differences in the E2 [（2 400 ± 1 116 vs. 909 ± 492 vs. 1 263 ± 662） pg / mL,P〈 0.01],P [（0.5 ± 0.4 vs. 6 ± 3 vs. 79 ± 38） ng / mL,P〈 0.01] levels on the day of HCG administration,OPU and ET were statistically significant in the pregnant group,and so were the E2 [（2 369 ± 1 225 vs. 797 ± 466 vs 1 161 ± 621 ） pg / mL,P 〈0.01],P [（0.52 ± 0.28 vs. 7 ± 4 vs. 87 ± 51） ng / mL,P〈 0.01] levels in the non-pregnant group. 【Conclusion】 The E2 level of the OPU day which increases gradually after OPU was significantly lower than that of the HCG administration day and the ET day. The significantly decrease of the E2 level after the HCG administration has no impact on clinical pre

关 键 词：雌二醇 孕酮 体外受精-胚胎移植(IVF-ET) 妊娠率 促性腺激素释放激素激动剂 

分 类 号：R329.1[医药卫生—人体解剖和组织胚胎学]