IVF-ET治疗周期中卵泡提前黄素化的相关因素分析  

Potential Causes of Premature Luteinization during the Treatment of in vitro Fertilization-embryo Transfer(IVF-ET)

作　　者：郭小桥[1] 孙筱放[2] 司沙沙[1] 麦紫欣[1] 雷鸣[1] 凌家炜[1] 刘见桥[1] 

机构地区：[1]广州医学院第三附属医院生殖医学中心,广州510150 [2]广东省普通高校生殖与遗传重点实验室、广州医学院第三附属医院,广州510150

出　　处：《生殖与避孕》2013年第11期749-754,共6页Reproduction and Contraception

基　　金：广州市科技和信息化局的2012年第4批科学技术经费项目(项目编号:2012Y2-000223)

摘　　要：目的:初步探讨控制性超促排卵(COH)过程中如何避免卵泡提前黄素化(premature luteinization,PL),提高IVF-ET妊娠率。方法:回顾性分析行GnRH-a黄体中期长方案的IVF-ET治疗患者的临床资料,共2 355个周期,根据hCG注射日孕酮(P)/雌二醇(E2)水平的比值是否>1分为PL组:即卵泡提前黄素化组,P/E2≥1,共63个周期;非PL组:即卵泡未提前黄素化组,P/E2<1,共2 292个周期。比较患者的一般资料及COH的参数资料,分析可能与PL相关的因素。结果:PL在GnRH-a长方案IVF-ET患者中的发生率为2.68%。女方年龄、男方年龄、女方体质量指数(BMI)、基础E2(bE2)、bLH、bFSH、不孕年限、治疗周期数、Gn启用剂量、hMG使用总量、hMG使用总天数、hCG注射日LH值组间差异无统计学意义(P>0.05)。PL组的Gn使用总量及Gn使用天数比非PL组的高,差异有统计学意义(P<0.05)。PL组的hCG注射日直径>15 mm卵泡数及MII卵数比非PL组的少,差异有统计学意义(P<0.05)。结论:PL在行GnRH-a长方案的IVF-ET治疗患者中的发生率为2.68%。Gn的使用天数,Gn总量过多,卵巢低反应可能是发生PL的相关因素,为避免发生PL可适当减少Gn的使用天数及Gn使用总量。Objective： To investigate how to avoid premature luteinization （PL） during controlled ovarian hyperstimulation （COH） and improve pregnancy rate. Methods： A total of 2 355 cycles who had undergone IVF-ET for infertility treatment were enrolled into the respective study. PL group consisted of the patients with PL of which P/E2 ratio on human chorionic gonadotropin （hCG） administration day was ≥1 （n=63） and non-PL group consisted of the patients whose P/E2 ratio was 〈1 （n=2 292）. The differences between the two groups in clinical parameters were compared. Results： The incidence rate of PL was 2.68%. The differences had no statistical significance between the two groups in the female age, male age, woman＇s body mass index （BMI）, the basic levels of E2, LH, FSH, the duration of infertility, treatment cycles, initial dasages of gonadotropin （Gn）, total dosages of hMG used, duration of hMG stimulation, serum LH level on the day of hCG injection （P〉0.05）. But the total dosages of Gn used and duration of Gn used in PL group were significantly higher than those in non-PL group （P〈0.05）. The number of follicles with the diameter〉 15 mm on the hCG injection day and the number of Mn egg in PL group were less than those in non-PL group （P〈0.05）. Conclusion： The total dosages of Gn used, the duration of Gn used, poor ovarian response may be relate to the PL. To reduce the incidence of PL, we had better decrease the total dosages of Gn used and the dosage of Gn started.

关 键 词：IVF-ET 卵泡提前黄素化(PL) 控制性超促排卵(COH) 

分 类 号：R714.8[医药卫生—妇产科学]