血清孕激素对体外受精-胚胎移植结局的影响  

Effect of serum progesterone level in controlled ovarian stimulation on in vitro fertilization embryo transfer.

作　　者：黄琼[1] 

机构地区：[1]贵阳市妇幼保健院妇产科,贵州贵阳550002

出　　处：《贵州医药》2015年第1期10-13,共4页Guizhou Medical Journal

摘　　要：目的研究晚卵泡期血清孕激素（P）水平对体外受精-胚胎移植结局的影响。方法收集贵阳市妇幼保健院生殖中心2011年~2012年间完成的体外受精-胚胎移植/卵胞质内单精子注射（IVF-ET/ICSI）共178周期病历资料,按注射hCG日血清孕激素浓度不同分为三组：第1组（78例）,血清孕激素≤2.5nmol/L;第2组（76例）：血清孕激素2.5nmol/L〉血清孕激素≤5.0nmol/L;第3组（24例）：血清孕激素〉5nmol/L。分析实验室反映卵子和胚胎质量的相关指标及其临床治疗结果,比较晚卵泡期血清孕激素水平对体外受精-胚胎移植结局的影响。根据以上分组标准,选择其中45例,应用化学发光法测定和观察控制性卵巢刺激中卵泡期孕激素变化规律。结果第1组平均获卵子数、MⅡ卵子数明显低于第2组（P〈0.05）,第3组受精率明显低于第2组（P〈0.01）,三组间优质胚胎形成率差异有统计学意义（P〈0.01）,第2组优质胚胎形成率最高,第3组最低。第1组,第3组,临床妊娠率明显低于第2组,分别为28.57%、41.09%,但差异无统计学意义（P〉0.05）。三组间hCG注射日血清LH水平及流产率差异无显著性（P〉0.05）。获卵子数及MⅡ卵子数与血清孕激素水平均呈正相关（分别为r=0.253,P〈0.01及r=0.245,P〈0.01）。hCG注射日血清LH和孕激素无相关性（r=0.026,P=0.841〉0.05）。结论 （1）控制性卵巢刺激中晚卵泡期血清孕激素≤2.5nmol/L和血清孕激素〉5.0nmol/L均可能对卵子和胚胎质量产生影响,并使临床妊娠率降低。此期血清孕激素水平是决定hCG注射时间及预测IVF妊娠结局的一个重要参数;（2）在控制性卵巢刺激中,血清孕激素浓度随卵泡增大及卵泡数目增多而升高,晚卵泡期血清孕激素适当上升是卵泡发育所必须。Objective To study the effect serum progesterone （serum P） level in the follicular phase of controlled ovarian stimulation （COS） in vitro fertilization embryo transfer （IVF-ET）. Method One hundred and seventy-eight infertile couples that accepted IVF and/or intracytoplasmic sperm injection （ICSI） treatment cycles were evaluated retrospectively in this study. All cycles were divided into three groups according to serum P level on the day of hu- man chorionic gonadotropin （hCG） injection： group one （serum P≤2. 5 nmol/L, 78 cases）, group two（serum P 〉2.5 nmol/L and ≤5.0 nmol/L, 76 cases）, and group three （serum P〉5 nmol/L, 24 cases）. Furthermore, Curve of serum P level in COS in three groups was studied according to the above standard. Result The number of o- ocytes retrieved and metaphase of second meiosis oocytes in the group one were lower than that of in the group two （P〈0.05）. The fertilization rates, high-quality embryo rates and clinical pregnancy rates in the group three were lower than that of the group two（P〈0.01, P〈0.01, P〈0. 05）. There were no significant difference in the serum LH level and abortion rates on all groups（P 〉0. 05）. There were a positive correlation between the serum P and the number of oocytes（r=0. 253 ,P〈0.01）, as well as the serum P and metaphase of second meiosis oocytes（r=0. 245, P〈0. 01）. Conclusion The clinical pregnancy rates decreased in the cases of the serum P≤2. 5 nmol/L and ）5.00 nmol/L in the late follicular phase in controlled ovarian stimulation. It is necessary that increased serum pro- gesterone （serum P） level in the late follicular phase of controlled ovarian stimulation （COS）. The progesterone level on the day of hCG injection is a good guideline in predicting the outcomes of IVF.

关 键 词：控制性卵巢刺激 体外受精-胚胎移植 血清孕酮 

分 类 号：R714.8[医药卫生—妇产科学]