孕激素抑制LH峰在控制性卵巢刺激过程中的疗效观察  

Effect of progesterone used to prevent LH surges in controlled ovarian stimulation

作　　者：朱秀娴[1,2] 章晓乐[1,3] 傅永伦[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院辅助生殖科,上海200011 [2]上海交通大学医学院九院临床医学院,上海200011 [3]上海中医药大学附属曙光医院妇产科,上海201203

出　　处：《生殖与避孕》2015年第6期384-388,共5页Reproduction and Contraception

摘　　要：目的：探讨在控制性卵巢刺激（COS）过程中应用孕激素抑制黄体生成素（LH）峰的临床效果。方法：回顾性分析83例行体外受精/卵胞质内单精子注射-冻融胚胎移植（IVF/ICSI-FET）患者的资料,所有患者均采用孕激素联合促性腺激素方案,83个取卵周期共完成了92个FET周期,统计分析促排卵过程中的激素变化、胚胎实验室情况及妊娠结局。结果：在促排卵过程中,LH持续低水平,基础、中期（月经第9~11日）、诱发排卵当日LH水平分别为3.85±2.03 IU/L、3.64±2.01 IU/L、2.62±1.77 IU/L,未监测到LH峰。h MG的用药剂量为1 964.76±468.73 IU,孕激素（商品名：安琪坦）的用药剂量为2.05±0.34 g。平均获卵数为10.9±6.1,每个取卵周期平均冷冻5.0±2.5个胚胎。FET后临床妊娠率为52.17%（48/92）,胚胎种植率为39.34%（72/183）,流产率为10.42%（5/48）。结论：孕激素能够有效抑制LH峰,孕激素联合Gn促排卵方案为基于FET的促排卵技术提供了新的备选方案。Objective： To explore whether progesterone（P） can be used clinically to prevent LH surges in controlled ovarian stimulation（COS） for IVF cycle with the subsequent frozen-thawed embryo transfer（FET）. Methods： A total of 83 patients undergoing COS in a gonadtropin（Gn） and P（trade name： Utrogestan）protocol were analyzed. After COS, 92 FET cycles had been finished. The changes of hormones during COS, the embryo information and the pregnancy outcomes were analyzed. Results： The LH levels on day 3, day 9-11 and the trigger day were 3.85±2.03 IU/L, 3.64±2.01 IU/L, 2.62±1.77 IU/L, respectively, and premature LH surges were not detected. The dose of Gn was 1 964.76±468.73 IU, and the dose of progesterone was 2.05±0.34 g. The number of oocytes retrieved was 10.9±6.1 and the number of cryopreserved embryos was 5.0±2.5. After FET, the clinical pregnancy rate was 52.17%（48/92）, the implantation rate was 39.34%（72/183）, and the abortion rate was 10.42%（5/48）. Conclusion： The usage of progesterone is an effective method to inhibit the premature LH surges, and the Gn and P protocol is a novel protocol in combination with FET.

关 键 词：孕激素 黄体生成素(LH)峰 安琪坦 控制性卵巢刺激(COS) 冻融胚胎移植(FET) 

分 类 号：R714.8[医药卫生—妇产科学]