黄体中晚期雌二醇水平对体外受精-胚胎移植结局的预测  

Estradiol level in mid and late luteal phase is predictive of in-vitro fertilization outcome

作　　者：易艳红[1] 黄睿[1] 吴敬之[1] 黄翠玉[1] 王艳芳[1] 蔡倩方[1] 李伟栋[2] 

机构地区：[1]广东省妇幼保健院生殖中心,广州510010 [2]中山大学公共卫生学院

出　　处：《中国生育健康杂志》2010年第5期277-279,284,共4页Chinese Journal of Reproductive Health

摘　　要：目的 探讨黄体中晚期（胚胎移植后7 d）雌二醇（E2）水平对体外受精-胚胎移植（IVF-ET）妊娠结局的预测作用.方法 对2007年1～12月在广东省妇幼保健院生殖中心接受IVF-ET治疗的478个长方案IVF-ET周期进行分析,黄体支持单用黄体酮,胚胎移植后7 d测定血E2值.采用受试者工作特征曲线（ROC）对黄体中晚期E2值进行分析,以E2值820 pmol/L为预测妊娠的分界点,分为E2〈820 pmol/L组和E2≥820 pmol/L组,比较两组临床妊娠率和种植率.结果 以820 pmol/L为预测妊娠的分界点时,灵敏度为72.9%（153/210）,特异度为73.1%（196/268）,约登指数为0.46.阳性预测值为68.0%（153/225）,阴性预测值为77.5%（196/253）.临床妊娠率和种植率E2 ≤820 pmol/L组分别为68.0%（153/225）、44.7%（219/490）,E2〈820 pmoL/L组临床分别为22.5%（57/253）和11.3%（64/567）,差异有统计学意义（P〈0.01）.结论 黄体中晚期E2值对IVF-ET妊娠结局有一定的预测作用.Objective To explore the role of estradiol level in mid and late luteal phase （the 7th day after embryo transfer） in the prediction of in-vitro fertilization outcome. Methods A total of 478 in vitro fertilization-embryo transfer （IVF-ET） cycles were enrolled in this retrospective study according to their medical records. The patients were divided into two groups according to the cutoff of estradiol levels on the 7th day following ET. All patients started with a long protocol pituitary down-regulation with gonadotropin-re- leasing hormone agonist （GnRH-a）. Blood samples were tested for estradiol levels on the day of HCG injec- tion, the day after oocyte retrieval, and the 7th day following ET. The average E21evels on the 7th day fol- lowing ET were 〈 820 pmol/L in Group A, while E2 i〉 820 pmol/L in Group B. Results The clinical pregnancy rate （68.0 % ） and the implantation rate （44.7 % ） in Group B were significantly higher than those in Group A （22.5 % and 11.3 % , respectively） . The average E2 level on the 7th day after ET in pregnant group was significantly higher than that in non-pregnant group （P 〈 0. O1 ）. Conclusion Serum E2 levels in mid and late luteal phase may be important in the prediction of IVF outcome.

关 键 词：体外受精一胚胎移植 雌二醇 黄体中晚期 妊娠率 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]