长方案降调节后黄体生成素变化对体外受精-胚胎移植结局的影响  

The effect of luteinizing hormone change after down regulation in the long protocol on the outcome in vitro fertilization-embryo transfer

作　　者：黎淑贞[1] 陈希曦[1] 邓爱民[1] 郭江华[1] 陈晓燕[1] 

机构地区：[1]广东省江门市中心医院生殖中心,广东江门529030

出　　处：《华北煤炭医学院学报》2011年第2期146-148,共3页Journal of North China Coal Medical College

摘　　要：①目的探讨长方案超促排卵(COH)过程中黄体生成素(LH)的变化对体外受精-胚胎移植结局(IVF-ET)的影响。②方法将患者分3组:第1组:绒毛膜促性腺激素(HCG)日的LH>启动日LH,在COH中添加促性腺激素(HMG);第2组:HCG日的LH≤启动日LH,在COH中添加了HMG;第3组:HCG日的LH≤启动日LH,在COH中未添加HMG。比较3组患者的获卵数、受精率、卵裂率、可用胚胎率、优胚率、种植率、移植周期临床妊娠率。③结果降调天数及剂量,启动日的E2、FSH,HCG日的E2、P,子宫内膜厚度,Gn总量没有统计学差异。组1、2间Gn天数无差异,均显著高于组3(P<0.01);组1启动日LH显著低于组2、3(P<0.01),组2、3间无显著差异。组1 HCG日LH显著高于组2(P<0.01),组3 HCG日LH高于组2(P<0.05)。组1的获卵数低于组2(P<0.05),组1与组3、组2与组3间无统计学差异。移植胚胎数、可用胚胎率、种植率、移植周期临床妊娠率无统计学差异。组1、2间受精率、卵裂率、优胚率无差异,受精率低于组3(P<0.01),卵裂率、优胚率高于组3(P<0.01)。④结论在卵巢达到降调标准后,启动日LH低于0.5IU/L,可能影响早期卵泡的募集和受精,适当添加HMG,有利于卵泡募集,获得较多的卵子,并有利于其成熟受精,即使血清LH未上升。在卵泡发育晚期,垂体逐渐恢复LH分泌,有利于IVF-ET结局。此外,添加HMG后血清LH水平并未同步上升,故不能根据血清LH水平决定HMG的剂量。Objective To investigate the effect of luteinizing hormone（LH） after down regulation in the long protocol on the outcome in vitro fertilization-embryo transfer（IVF-ET）.Methods The research data were divided into 3 groups,according to the following criteria,Group1：HCG day LH start day LH,and HMG added in COH;Group 2：HCG day LH ≤ start day LH,and HMG added in COH;Group3：HCG day LH ≤ start day LH,but HMG did not added in COH.Compared the number of oocytes,fertilization rate,cleavage rate,aviable embryo rate,high-quality embryo rate,implantation rate,clinical pregnancy rate of transfer cycles were compared among the three groups.Results There were not significant differences in down regulation days and the dose,start date of E2,FSH,HCG day E2,P,endometrial thickness,total dose of Gn among three groups.The days used gonadotropin（Gn） were not different between Group 1,2.Both of them were significantly higher than those in group 3（P0.01）.Started day LH in Group 1 was significantly lower than that in group 2,3（P0.01）,and started day LH between group 2 and 3 were no significant difference.HCG day LH in group 1 was significantly higher than group 2（P0.01）,HCG day LH in group 3 was higher than that in group 2（P0.05）.The number of oocytes in Group 1 was less than that in group 2（P0.05）.There was no statistical difference between group 1 and group 3,as well as group 2 and group 3.Available embryos rate,implantation rate and pregnancy rate among the three groups were not statistical significant.Fertilization rate,cleavage rate and high-quailty embryo rate were almost the same in Group 1 and Group 2,however,fertilization rate in them was both lower than that in Group 3（P0.01）,while cleavage rate,high-quailty embryo rate were all higher than those in Group 3（P0.01）.Conclusion After Achieving the standard of down regulation,if the LH on start day was lower than 0.5 IU/L,adding HMG reasonably contributed to the follicle recruitment for retrieved more oocytes,as well as fertilizatio

关 键 词：体外受精-胚胎移植 黄体生成素 

分 类 号：R329.1[医药卫生—人体解剖和组织胚胎学]