长方案控制性超促排卵过程中黄体生成素水平对多囊卵巢综合征患者IVF-ET结局的影响  

Effect of luteinizing hormone variation on clinical outcomes in patients with polycystic ovarian syndrome undergoing in vitro fertilization-embryo transfer using standard long protocol

作　　者：阎梦 华芮[1] 周瑶[1] 聂庆文[1] 李红[1] 

机构地区：[1]南方医科大学南方医院妇产科生殖中心,广东广州510515

出　　处：《南方医科大学学报》2016年第3期381-385,共5页Journal of Southern Medical University

基　　金：国家科技支撑计划(2013BAI12B00)~~

摘　　要：目的探讨控制性超促排卵(COH)过程中黄体生成素(LH)变化趋势对多囊卵巢综合征(PCOS)患者体外授精-胚胎移植(IVF-ET)结局的影响。方法回顾性分析首次接受IVF-ET治疗、使用经典长方案的PCOS患者314例,根据早、中、晚卵泡期血清LH水平分为早-中卵泡期降低组(A组,LH比值≤1)与升高组(B组,LH比值>1)、中-晚卵泡期降低组(C组,LH比值≤1)与升高组(D组,LH比值>1)、早-晚卵泡期降低组(E组,LH比值≤1)与升高组(F组,LH比值>1),比较A与B、C与D、E与F组间结局的差异。结果 A、B两组间临床结局差异无统计学意义(P>0.05)。C组获卵数、早期自然流产率较D组显著升高(P<0.05),而正常受精率、胚胎种植率、临床妊娠率、持续妊娠率较D组显著降低(P<0.05)。E组早期流产率较F组显著升高(P<0.05),持续妊娠率较F组显著下降(P<0.05),其它指标组间比较差异无统计学意义(P>0.05)。结论早-晚卵泡期与中-晚卵泡期LH呈升高趋势有更好的临床结局,早-中卵泡期LH变化趋势对临床结局无影响。Objective To evaluate the effect of serum luteinizing hormone（LH） variation on clinical outcomes in patients with polycystic ovarian syndrome（PCOS） undergoing in vitro fertilization- embryo transfer（IVF- ET）. Methods A retrospective analysis was conducted in 314 patients with PCOS undergoing their first IVF cycle using standard long protocol. On the basis of LH concentrations on early-, mid- and late-follicular phase, the patients were divided into decreased LH（LH ratio≤1, group A） and increased LH（group B, LH ratio1） groups in early- to mid-follicular phase, decreased LH（group C） and increased LH（group D） groups in mid- to late-follicular phase, and decreased LH（group E） and increased LH（group F, LH ratio1） in earlyto late-follicular phase. The clinical outcomes were compared between groups A and B, groups C and D, and between groups E and F. Results No significant differences were found in the clinical outcomes between group A and B（P〈0.05）. The number of oocytes retrieved and the early abortion rate were significantly lower, but the normal fertilization rate, implantation rate,clinical pregnancy rate and ongoing pregnancy rate were significantly higher in group D than in group C（P〈0.05）. In group F,the early abortion rate was significantly lower and the ongoing pregnancy rate was significantly higher than those in group E（P〈0.05）, and no significant differences were found in other clinical outcomes between the two groups（P〈0.05）. Conclusion An increase in LH level from early- or mid- to late- follicular phase has a positive effect on the clinical outcomes, but this LH variation in early- to mid-follicular phase does not affect the clinical outcomes.

关 键 词：黄体生成素变化趋势 长方案 多囊卵巢综合征 体外授精-胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]