人绒毛膜促性腺激素注射日血清激素水平对体外受精-胚胎移植临床的影响  

The relationship among serum progesterone(P),estrogen(E_2),P/E_2 ratio on the day of HCG administration and the outcomes of IVF-ET

作　　者：丁玉芹[1] 姜宏[1] 汪存利[1] 张文香[1] 王雪梅[1] 

机构地区：[1]安徽医科大学解放军临床学院生殖中心,合肥230031

出　　处：《安徽医学》2010年第11期1320-1323,共4页Anhui Medical Journal

摘　　要：目的探讨控制性超排卵(controlled ovarian hyperstimulation,COH)中人绒毛膜促性腺激素(human chorionic goadotrophin,HCG)注射日孕激素(P)、雌二醇(E2)水平及P/E2对体外受精-胚胎移植(IVF-ET)临床结局的影响。方法回顾性分析采用黄体中期长方案治疗的322个完整IVF-ET周期的临床资料。结果按血清P值分为A1组(<2.86nmol/L),B1组(2.86～9.54nmol/L),C1组(>9.54nmol/L),3组间妊娠率差异无统计学意义(P>0.05)。按E2水平分为A2组(<1500pg/ml)、B2组(1500～3000pg/ml)、C2组(>3000pg/ml),随E2增高获卵数增多,Gn用量逐渐减少,各组间差异有统计学意义(P<0.05);3组间胚胎着床率和临床妊娠率差异无统计学意义(P>0.05);B3组(P/E2≥1.2)胚胎着床率和妊娠率显著低于A3组(P/E2<1.2)(P<0.05)。结论在长方案IVF-ET治疗中注射HCG日血清E2水平与获卵数和Gn用量有关,P/E2比值是预测IVF-ET临床结局有价值的指标,而P和E2值不能预测妊娠结局。Objective To investigate the relationship among Serum Progesterone（P）,Estrogen（E2） ,P/E2 ratio on the day of HCG administration and the outcomes of In Fertilization and Embryo Transfer（IVF-ET）.Methods The data of 322 IVF-ET cycles with long GnRH-a protocols,were analyzed retrospectively.Results According to Serum Progesterone （P） and Estrogen（E2） on the day of HCG administration,all patients were divided into three groups,respectively.It was found that there was no significant difference in pregnancy rate among the A1（P≤2.86 nmol/L）,B1（P=2.86 nmol/L～9.54 nmol/L） and C1（P〉9.54 nmol/L） groups（P〉0.05）,and the rates of embryo implantation and clinical pregnancy were found no significant difference among A2（E21500pg/mL）、B2（E2=1500~3000 pg/mL） and C2（E23000pg/mL） groups （P〉0.05）,But as the number of retrieved oocytes increased and the dose of gonadotropin degreased,The rates of embryo implantation and pregnancy in B3（P/E2≥1.2） group were significantly lower than A3（P/E21.2） group（P〈0.05）.Conclusion The numbers of retrieved oocytes and the doses of gonadotropin are related to the serum E2 level,and the ratio of P/E2 is a valuable index for predicting IVF-ET outcomes.But the serum E2 and P level on the day of HCG administration cannot be used to predict the outcomes of IVT-ET with long GnRH-a protocols.

关 键 词：受精 胚胎移植 孕激素 雌激素 妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]