血清和卵泡液中雌激素及孕激素水平及其比值与获卵数和妊娠结局的关系  

Relationship between the Oocytes Number,Pregnancy Outcome and Estradiol Level,Progesterone Level,and Estradiol/Progesterone Ratio in the Serum and Follicular Fluid in the Treatment of IVF-ET

作　　者：谭欣[1] 贺贞[1] 左涛[2] 郭建[1] 杨丹[1] 朱明辉[1] 

机构地区：[1]成都中医药大学第二附属医院,四川成都610041 [2]四川大学,四川成都610065

出　　处：《实用妇产科杂志》2014年第3期216-219,共4页Journal of Practical Obstetrics and Gynecology

基　　金：四川省科技厅科技支撑计划项目(编号:2011FZ0019)

摘　　要：目的：探讨体外受精一胚胎移植（IVF—ET）治疗时血清和卵泡液中雌激素（E2）、孕激素（P）水平及其比值与获卵数和妊娠结局的关系。方法：45例接受IVF／卵泡浆内单精子显微注射（ICSI）治疗的患者，检测HCG日及取卵日血清和卵泡液中E2、P水平，按照获卵数分为A组（1～5个）、B组（6—15个）、C组（〉15个），分析各组血清和卵泡液中E2、P值，受精率、优质胚胎率及临床妊娠率的差异。结果：①HCG日血清E2和取卵日血清E2及P比较，3组差异均有统计学意义（P〈0．05）：A组〈B组〈C组。②HCG日血清E2／P比较差异有统计学意义，E2／P比值A组〈B组〈C组；取卵日P水平较HCG日上升，尤其是C组显著上升，E2／P比值表现为A组〈C组〈B组。③B组临床妊娠率（74．O％）高于A组（36．4％）及c组（40．0％），差异有统计学意义（P〈0．05），而C组与A组临床妊娠率比较差异无统计学意义（P〉0．05），3组受精率及优质胚胎率比较差异均无统计学意义（P〉0．05）。④各组卵泡液中E2、P、E2／P比较，差异均无统计学意义（P〉0．05）。结论：血清E2、P水平与获卵数有关；适当的获卵数和E2、P比值妊娠率更高。Objective：To explore the relationship between the number of oocytes, pregnancy outcomes and estradiol level, progesterone level, and estradiol/progesterone ratio in the serum and follicular fluid in the treatment of In vitro fertilization-embryo transfer （IVF-ET）. Methods： 45 IVF/ICSI （Intracytoplasmic sperm injection）patients participated in this research, whose estradiol and progesterone in the follicular fluid and serum on the day of HCG administration and oocyte retrieval were detected. Then they were assigned into 3 groups according to the number of oocytes as follow：Group A （1 -5）, Group B （6 -15）, and Group C （ 〉 15%）. Analysis was conducted on the differences among the three groups. Results：（1）there were signif- icant differences among three groups in the estradiol level of serum on the day of HCG administration, as well as the estradiol level and progesterone level of serum on the clay of oocyte retrieval： Group A 〈 Group B 〈 Group C. ~there were significantly differences in the E2/P of serum on the day of HCG administration a- mong the groups： Group A 〈 Group B 〈 Group C; P levels on the day of oocyte retrieval was higher than that on the day of HCG administration, especially in group C. E2/P ratio was group A 〈group C 〈group B. the clinical pregnancy rate in group B （74.0%） was higher than that in group A （36.4%） and group C （40.0%）. However, there was no significant difference between Group A and Group C. （4）there was no sig- nificant difference in the estradiol level, progesterone level, or E2/P in follicular fluid, fertilization rate or the ratio of the high-quality embryos among groups. Conclusions：The estradiol and the progesterone levels were positively correlated with the number of oocytes. The appropriate number of oocytes and E2/P may lead to higher pregnancy rate.

关 键 词：体外受精-胚胎移植 雌二醇 孕酮 子宫内膜容受性 控制性超排卵 

分 类 号：R715[医药卫生—妇产科学]