HCG注射日血清雌孕激素对试管婴儿妊娠结局的影响  

The effect of HCG-day serum progesterone and estradiol concentrations on pregnancy outcomes in IVF/ICSI-ET cycles

作　　者：周丹妮[1] 杨菁[1] 吴庚香[1] 李赛姣[1] 余楠[1] 赵萌[1] 文妍琪[1] 

机构地区：[1]武汉大学人民医院生殖医学中心,武汉430060

出　　处：《中国工程科学》2014年第5期79-84,共6页Strategic Study of CAE

摘　　要：探究体外受精—胚胎移植/单精子卵泡浆内注射-胚胎移植(IVF/ICSI)患者注射人绒毛膜促性腺激素(HCG)日血清雌孕激素水平对妊娠结局的影响。回顾分析武汉大学人民医院生殖医学中心2011年9月—2012年9月符合相关条件行IVF的新鲜周期患者1 270例,按血清孕酮值将其分为两组进行比较,低孕酮组HCG日血清孕酮值<2.0 pg/mL,高孕酮组HCG日血清孕酮值≥2.0 pg/mL;再按照孕酮与雌二醇比值(P/E2)分为两组,以0.6作为P/E2切点。比较两组间的女方年龄、不孕年限、基础卵泡刺激素(FSH)值、促性腺激素(Gn)天数、Gn用量、获卵数、MII卵数、受精数、卵裂数、优胚数、移植数、E2值、临床妊娠率、胚胎着床率。高孕酮组Gn天数、Gn用量、获卵数、MII数、卵裂数、E2值增加,但临床妊娠率、胚胎着床率减少;高P/E2比值组女方年龄、基础FSH、Gn天数、Gn用量、获卵数、受精数、优胚数、P值均增加,妊娠结局无明显差异。HCG注射日血清孕酮水平过高会降低临床妊娠率及胚胎着床率。To evaluate the effect of serum progesterone and estradiol concentrations on day of injecting human chorionic gonadotropinon（HCG） on the pregnancy outcomes in the invitro fertilization/intracytoplasmic sperm injection（IVF/ICSI） patients. From Sep. 2011 to Sep. 2012,1 270 fresh IVF cycles who comply with relevant conditions were analyzed retrospectively in Reproductive Medicine Center in Renmin Hospital of Wuhan University. And according to the serum progesterone value,the patients are divided into two groups,One group is the value of serum progestrone which is less than 2.0 pg/mL on the day of injecting HCG,the other is the value of serum progestrone which is equal or greater than 2.0 pg/mL on the day of injecting HCG.Then in terms of the ratio about progesterone and estradiol（P/E2）,the patients are divided into two groups with 0.6 as P/E2cut-off point. Compared women＇s age,duration of infertility,basic follicle stimulating hormone（FSH） values,the total doses of gonadotropin,the duration of stimulation,number of oocytes retrieved,number of MII oocytes,number of fertilization,number of cleavage,number of high qualified embryo,number of embryos transferred per cycle,estradiol level on the HCG day,clinical pregnancy rate（%）,embryo implantation rate（%）. The higher concentration of progesterone group had more total doses of gonadotropin, duration of stimulation,number of oocytes retrieved,number of MII oocytes,number of cleavage,E2value,but the clinical pregnancy rate, embryo implantation rate were statistically decrease. There was an increase in the age of female patien, basic FSH values and total doses of gonadotropin, duration of stimulation,number of oocytes retrieved, number of fertilization, number of high qualified embryo,P values in higher P/E2ratio group. However, there was no obvious difference was found between the pregnancy outcome. Conclusion on day of injecting HCG,serum progesterone levels can reduce clinical pregnancy rates and embryo implantation rate.

关 键 词：孕酮值 HCG日 IVF/ICSI新鲜周期 临床妊娠率 

分 类 号：R715.2[医药卫生—妇产科学]