体外受精-胚胎移植周期晚卵泡期血清孕激素水平对治疗结局的影响  

Impact of serum progesterone levels during late follicular phase on treatment outcome in IVF-ET cycle

作　　者：吴霞[1] 谭晓珊[2] 谭兵兵[2] 张振东[2] 

机构地区：[1]安徽省皖北煤电集团总医院生殖中心,宿州234000 [2]遵义医学院附属医院生殖中心,遵义563000

出　　处：《生殖医学杂志》2012年第1期38-42,共5页Journal of Reproductive Medicine

摘　　要：目的探讨体外受精-胚胎移植(IVF-ET)周期晚卵泡期血清孕激素(P)水平对实验室、临床指标的影响。方法对行IVF-ET的436个周期的临床资料进行回顾性分析。以4≤获卵数≤15及获卵数>15将患者分为卵巢正常反应组及卵巢高反应组,每组再根据人绒毛膜促性腺激素(hCG)注射日血清P水平按四分位距法分为四个亚组,即卵巢正常反应组:A1、B1、C1、D1;卵巢高反应组:A2、B2、C2、D2。分别对各组实验室、临床指标进行分析比较。结果卵巢正常反应组中,各亚组的MⅡ卵率、正常受精率比较,无显著性差异(P>0.05);四个亚组中,B1组的优胚率、可移植胚胎率、正常卵裂速度胚胎率、胚胎种植率、周期临床妊娠率最高(P<0.05),以D1组周期流产率最高(P<0.05)。卵巢高反应组中,各组的获卵率、MⅡ期卵率、可移植胚胎率比较,无显著性差异(P>0.05);四个亚组中,B2组的优胚率、正常受精率、正常卵裂速度胚胎率最高(P<0.05)。结论不同卵巢反应组中晚卵泡期血清P水平均有一最适宜范围,若血清P水平明显升高,可对实验室和临床指标产生不利影响。Objective： To explore the correlation between serum progesterone levels and the laboratory and clini- cal parameters in IVF-ET cycle. Methods： The clinical data of 436 IVF-ET cycles were analyzed retrospectively. The patients were divided into the normal ovarian response group （oocyte number ≥4 and≤15） and high ovarian response group （oocyte number 〉15） according to retrieved oocytes numbers. Then each group was divided into four subgroups according the serum progesterone levels on the day of injection of human chorionic gonadotropin （hCG）, namely, A1, B1, C1, D1 in the normal ovarian response group, and A2, B2, C2, D2 in high ovarian response groups. The laboratory parameters and the clinical parameters were analyzed for all the groups. Results： In the normal ovarian response group, the ratio of M II phase oocyte and normal fertilization rate were not significantly different among the four subgroup（P〉0.05）. The good quality embryo rate, transplantable embryo rate, normal cleavage rate, embryo implantation rate and clinical pregnancy rate were the highest in 131 subgroup among four subgroup（P^0.05）. The incidence of miscarriage was the highest in D1 subgroup among four subgroup（P^0.05）. In the high ovarian response group, there were no significantly differences in the ratio of retrieved oocyte, the ratio of M II phase oocyte and the ratio of transplantable embryo among four subgroup（P^0.05）. The good quality embryo rate, normal fertiliza- tion rate and normal cleavage rate were the highest in B2 subgroup among four subgroup（P^0.05）. Conclusions： In different ovarian response group, there was an optimal appropriate range of serum progesterone levels in the late follicular phase. If the serum progesterone levels significantly rise, it may have adverse effect on the laboratory and clinical parameters during late follicular phase in IVF-ET cycle.

关 键 词：体外受精-胚胎移植 晚卵泡期 孕激素 

分 类 号：R[医药卫生]