重组人促黄体生成素对排卵障碍性不孕患者IVF治疗结局的影响  

Effects of recombinant human luteinizing hormone on outcome of IVF treatment in patients with dysfunctional ovulatory sterility

作　　者：李柯瑾 陈瑞红[2] LI Ke-jin;CHEN Rui-hong(Fuxing Hospital Affiliated to Capital Medical University, 100038;Second Affiliated Hospital of Zhengzhou University 450003)

机构地区：[1]首都医科大学附属复兴医院,北京100038 [2]郑州大学第二附属医院,河南450003

出　　处：《中国优生与遗传杂志》2019年第6期755-757,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的观察重组人促黄体生成素(r-hLH)对排卵障碍性不孕患者体外受精-胚胎移植(IVF-ET)治疗结局的影响。方法对2017年1月至2018年1月郑州大学第二附属医院142例行IVF-ET治疗的排卵障碍性不孕患者临床资料进行回顾性分析,根据其垂体降调节后月经第3d血清黄体生成素(LH)水平及补充r-hLH情况将患者分为A组(r-hLH组,LH水平<1IU/L且行补充r-hLH治疗,n=48)、B组(非r-hLH组,LH水平<1IU/L且未予以r-hLH治疗,n=42)及C组(对照组,LH水平>1IU/L且未予以r-hLH治疗,n=52)。于人绒毛膜促性腺激素(HCG)日检测3组患者血清LH、雌二醇(E2)水平;比较3组患者促性腺激素(Gn)用量、平均获卵数和平均移植胚胎数差异;于HCG日采集患者血清,于取卵日采集患者卵泡液,检测血清、卵泡液骨形态发生蛋白-15(BMP-15)水平;观察IVF-ET治疗结局。结果 A组血清LH、E2水平均高于B组,血清LH水平低于C组(P<0.05);A、C组血清E2水平无显著性差异(P>0.05)。3组Gn用量、平均获卵数和平均移植胚胎数无显著性差异(P>0.05)。A组HCG日血清BMP-15及取卵日卵泡液BMP-15水平均高于B组,低于C组(P<0.05)。A、C组2PN率均高于B组(P<0.05),A、C组组间无显著性差异(P>0.05)。A、B组优质胚胎率均低于C组(P<0.05),A、B组组间无显著性差异(P>0.05)。3组着床率、临床妊娠率无显著性差异(P>0.05)。结论 r-hLH可有效提升长方案垂体降调节后LH过度抑制排卵障碍不孕患者HCG日的血清E2水平和卵母细胞质量,改善IVF-ET治疗结局。Objective:To observe the effects of recombinant human luteinizing hormone(r-hLH)on the outcome of in vitro fertilization-embryo transfer(IVF-ET)in patients with dysfunctional ovulatory sterility. Methods:The clinical data of 142 patients with dysfunctional ovulatory sterility treated with IVF-ET in our hospital from January 2017 to January 2018 were analyzed retrospectively. According to the serum luteinizing hormone(LH)level and r-hLH supplement at 3 rd d of menstruation after pituitary down-regulation,the patients were divided into group A(r-hLH group,LH level<1 IU/L,and with r-hLH treatment,n=48),and group B(non-r-hLH group,LH level<1 IU/L,and without r-hLH treatment,n=42)and group C(control group,LH level>1 IU/L,and without r-hLH treatment,n=52). The serum levels of LH and estradiol(E2)were measured on the day of human chorionic gonadotropin(HCG)in the three groups,and the gonadotropin(Gn)usage,mean retrieved oocyte number,and average number of transferred embryos were compared among the three groups. On the day of HCG,the patient′s serum was collected. On the day of oocyte retrieval,the patient′s follicular fluid was collected,and the levels of bone morphogenetic protein-15(BMP-15)in serum and follicular fluid were detected,and the outcome of IVF-ET treatment was observed. Results:Serum levels of LH and E2 in group A were higher than those in group B,and serum LH level was lower than that in group C(P<0.05),and there was no significant difference in serum E2 level between group A and group C(P>0.05).There was no significant difference in the Gn usage,mean retrieved oocyte number,and average number of transferred embryos among the three groups(P>0.05). The serum levels of BMP-15 on day of HCG in serum and follicular fluid in group A were higher than those in group B and lower than those in group C(P<0.05). The rate of 2 PN in group A and group C was higher than that in group B(P<0.05),and there was no significant difference between groups A and C(P>0.05). The rate of high-quality embryos in groups A and B

关 键 词：重组人促黄体生成素 排卵障碍性不孕 体外受精-胚胎移植 治疗结局 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]