拮抗剂方案中卵泡期促黄体生成素水平对不同卵巢反应者体外受精-胚胎移植结局的影响  

Effect of luteinizing hormone level on the outcome of in vitro fertilization and embryo transfer in the different ovarian response patients with gonadotrophin-releasing hormone antagonist protocol

作　　者：农璎琦[1] 刘文娟 黄倩文[1] 黄莉[1] 李仕芬 周娜[1] 刘风华[1] Nong Yingqi;Liu Wenjuan;Huang Qianwen;Huang Li;Li Shifen;Zhou Na;Liu Fenghua(Guangdong Women and Children Hospital, Guangzhou 510010, China)

机构地区：[1]广东省妇幼保健院,广州510010

出　　处：《中华生殖与避孕杂志》2018年第3期192-199,共8页Chinese Journal of Reproduction and Contraception

摘　　要：目的探寻拮抗剂方案中添加拮抗剂的最佳时机及人绒毛膜促性腺激素(hCG)注射日合理的促黄体生成素(LH)水平区间。方法回顾性队列研究分析1 327例拮抗剂方案的取卵周期资料,根据基础窦卵泡数(AFC)将卵巢反应性依次分为卵巢低反应组(AFC≤5,n=278)、卵巢正常反应组(6≤AFC≤15,n=756)、卵巢高反应组(AFC≥16,n=293),并根据拮抗剂添加日及hCG注射日的LH水平再分组比较临床结局。结果 (1)在拮抗剂添加日,不同卵巢反应者LH<5 IU/L及≥5 IU/L组的妊娠结局差异均无统计学意义,但卵巢低反应者在LH≥5 IU/L时开始添加拮抗剂可能获得较高的优质胚胎率,卵巢正常反应者在LH≥5 IU/L时开始添加拮抗剂Gn使用时间较少。(2)在hCG注射日不同卵巢反应者的LH水平对其妊娠结局均无影响。结论拮抗剂添加日LH水平及hCG注射日LH水平均不影响拮抗剂方案的临床妊娠率,但不同卵巢反应者卵泡期适合的LH水平可能有所不同。Objective To explore the optimal time of adding antagonist and the reasonable range of luteinizing hormone （LH） level on the human chorionic gonadotropin （hCG） injection day. Methods The data of 1 327 cases of GnRH-A protocol were retrospectively analyzed. According to the antral follicle count （AFC）, the patients were divided into three groups： 1） poor ovarian responder （AFC≤5, n=278）; 2） normal ovarian responder （6≤AFC ≤15, n=756）; 3） high ovarian responder （AFC≥16, n=293）, and then each group was divided into two or three subgroups according to the LH level on antagonist administered day or the hCG injection day, the clinical outcomes were compared amomg the groups. Results 1） There were no significant differences in pregnancy outcomes between LH〈5IU/L and≥5 IU/L groups on the day of antagonist addition, but for the poor ovarian responders, administration of the antagonist when LH≥5 IU/L could get higher high-quality embryos rate; for the normal ovarian responders, administration of the antagonist when LH ≥5 IU/L could reduce the duration of Gn used. 2） Regardless of ovarian response, the serum LH level on the hCG injection day did not affect the pregnancy outcome. Conclusion The LH level on the antagonist administered day and the hCG injection day did not affect the pregnancy outcomes. However, the optimum LH level of follicular phase may vary in different ovarian responders.

关 键 词：拮抗剂方案 卵泡期促黄体激素(LH)水平 卵巢反应性 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]