取卵后48h较hCG注射日雌激素水平下降幅度对卵裂期胚胎移植结局的影响  

Effect of declining serum level of estradiol on pregnancy outcomes of embryo transfer in cleavage stage

作　　者：张雅洁[1] 郭艺红[1] 李婧[1] 杨新红[1] 

机构地区：[1]郑州大学第一附属医院,450052

出　　处：《中国计划生育学杂志》2015年第8期541-545,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨控制性超促排卵(COH)周期,采集卵母细胞(OPU)后48h较人绒毛膜促性腺激素(hCG)注射日雌二醇(E2)水平下降对卵裂期胚胎移植妊娠结局的影响。方法:回顾分析行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)助孕,卵裂期新鲜胚胎移植5048个周期的临床资料。根据取卵后48h较hCG日E2下降幅度分为下降≤60%组(618个周期)、下降>60%~80%组(3491个周期)、下降>80%组(940个周期),比较各组妊娠结局。结果:3组妊娠率分别为51.8%(320/618)、51.65%(1803/3491)、45.9%(432/940);早期流产率分别为9.1%(29/320)、10.5%(191/1803)、15.5%(67/432);异位妊娠率分别为2.8%(9/320)、3.4%(61/1803)、8.5%(87/432),差异均有统计学意义(P<0.05)。结论:随OPU后48h较hCG日血清E2水平下降幅度增加,卵裂期胚胎移植周期早期流产及异位妊娠的风险增加。Objective： To explore the effect of the decline of serum estradiol between human chorionic gonadotropin （hCG） injection day and 48 h after ovum pick-up （OPU） on pregnancy outcomes during controlled ovarian hyperstimu- lation （COH） of embryo transfer in cleavage stage. Methods： In this retrospectively study, 5048 in vitro fertilization/ intracytoplasmic sperm injection and day-3 embryo transfer （IVF/ICSI-ET） cycles were performed. According to the declining level of serum estradiol, day-3 embryo transfer cycles were respectively divided into 3 groups, with the de- cline of estradiol level of ~60~, 60%-80% and 〉80%, respectively. The clinical pregnancy outcomes were compared among groups. Results： The clinical pregnancy rates in A, B and C groups were 51.8% （320/618）, 51.65 （1803/ 3491） and 45.9% （432/940）, respectively （P^0.05）. Of these three groups, early spontaneous abortion rates were 9.1% （29/320）, 10.5% （191/1803） and 15.5% （67/432）, and ectopic pregnancy rates were 2.8% （9/320）, 3.4% （61/1803） and 8.5% （87/432）,respectively, showing significant differences （P all 〈0.05）. Conclusion： Higher decli- ning level of serum estradiol between hCG injection day and 48 h after OPU could result in higher incidence of early a- bortion rates and ectopic pregnancy rates in embryo transfer of the cleavage stage.

关 键 词：体外受精-胚胎移植 雌激素 卵裂期胚胎 妊娠结局 辅助生殖技术 

分 类 号：R714.8[医药卫生—妇产科学]