人绒毛膜促性腺激素注射日血清孕酮水平对体外受精妊娠结局的影响  

Impact of progesterone level on the day of human chorionic gonadotrophin administration on outcome of in vitro fertilization

作　　者：朱光丽[1] 苏迎春[1] 孙莹璞[1] 郭艺红[1] 胡琳莉[1] 

机构地区：[1]郑州大学第一附属医院生殖医学中心,郑州450052

出　　处：《现代妇产科进展》2011年第4期286-289,共4页Progress in Obstetrics and Gynecology

摘　　要：目的：探讨在控制性超排卵中，HCG注射日孕酮水平与体外受精妊娠结局的关系。方法：回顾性分析2009年6月～2010年5月在我院生殖中心采用长方案垂体降调节行体外受精助孕的1145个周期。按照HCG注射日血清孕酮水平的不同分为四组，A组：血清孕酮〈0．9ng／ml者313周期；B组：血清孕酮0．9～1．5ng／ml者411周期；C组：血清孕酮1．5～2．5ng／ml者337周期；D组：血清孕酮≥2．5ng／ml者84周期。结果：D组（P1≥2．5ng／m1）种植率和临床妊娠率明显降低，异位妊娠率明显升高，与其余各组比较有统计学意义（P〈0．05），而各组间受精率、卵裂率、优胚形成率及冻融胚胎移植周期临床妊娠率差异无统计学意义。结论：控制性超排卵中，HCG注射日孕酮升高仅影响了新鲜周期的妊娠结局，而不影响解冻周期的妊娠率。因此，高孕酮水平患者可考虑放弃新鲜胚胎移植，行全胚胎冷冻。Objective：To evaluate the impact of progesterone level on the day of human chorionic gonadotrophin administration on pregnancy outcome of in vitro fertilization in con- trolled ovarian hyperstimulation. Methods： Retrospective analysis the 1145 cycles of IVF-ET which were used with down-regulation long protocol in our reproductive medical centre from June 2009 to May 2010,and patients were divided into four groups according to serum proges- terone level on the day of HCG administration,group A：〈0.9ng/ml 313 cycles;group B ：0.9 1.5ng/ml 411 cycles ; group C ： 1.5 - 2.5ng/ml 337cycles ; group D ： ≥2.5ng/ml 84 cycles. Results：Compared with the other three groups, P≥2.5ng/ml group significantly reduced im-plantation and pregnancy rates but the extrauterine pregnancy rate was significantly higher（P〈 0.01 ）. There were no statistical differences in the number of fetilization rates, embryos cleavage rates, high quality embryos rates and clinical pregnancy rates of frozen-thawed embryo transfer cycles among the four groups. Conclusions：In controlled ovarian hyperstimulation, the increase of progesterone level on the day of human chorionic gonadotrophin administration has effect only on clinical pregnancy outcome of IVF-ET,without affecting on clinical pregnancy rate of frozenthawed Embryo Transfer. Therefore, the patients who have high progesterone levels may be considered giving up fresh embryo transfer and freezing total embryo.

关 键 词：孕酮水平 体外受精 控制性超排卵 

分 类 号：R711.6[医药卫生—妇产科学]