IVF-ET周期中雌激素浓度的变化与妊娠结局的关联性研究  

Study on correlation between changes of estrogen level and pregnancy outcome in IVF-ET cycle

作　　者：孙玉琴[1] 黄培 张睿[1] 邹淑花 SUN Yu-qin;HUANG Pei;ZHANG Rui;ZOU Shu-hua(Reproductive Medicine Center,Maternal&Child Health Hospital of Zibo City,Shandong Province,Zibo 255029;Reproductive Medicine Center,the International Peace Maternity&Child Health Hospital,Shanghai 200030)

机构地区：[1]山东省淄博市妇幼保健院生殖医学中心,淄博255029 [2]上海国际和平妇幼保健院生殖中心,上海200030

出　　处：《生殖医学杂志》2020年第12期1569-1575,共7页Journal of Reproductive Medicine

基　　金：淄博市妇幼保健院发展基金(F201706)。

摘　　要：目的评估在IVF-ET周期中自注射HCG日至卵裂期胚胎移植(ET)日连续6 d血雌二醇(E 2)浓度的变化与妊娠结局的关联性。方法回顾性分析自2017年1月至2020年1月在淄博市妇幼保健院生殖医学中心接受IVF-ET治疗的41例患者,分为妊娠组(n=20)和非妊娠组(n=21),比较组间自HCG日(d 0)起连续6 d检测血清E 2水平(d 0 E 2、d 1 E 2、d 2 E 2、d 3 E 2、d 4 E 2、d 5 E 2)的差异;根据取卵日(d 2)相对于HCG日的E 2比值(d 2 E 2/d 0 E 2)的四分位数(P25,P75)分为A组(<P25,n=10)、B组(P25~P75,n=21)和C组(>P75,n=10),并根据胚胎移植日(d 5)相对于HCG日E 2比值(d 5 E 2/d 0 E 2)的四分位数(P25,P75)分为D组(<P25,n=10)、E组(P25~P75,n=21)和F组(>P75,n=10),分析各组促排卵后各种指标的差异。结果妊娠组各时点血清E 2浓度均高于非妊娠组,但均无统计学差异(P>0.05)。在A、B、C三组中,B组的正常受精数(8.05±3.09)显著高于A组(5.20±2.94)和C组(5.60±3.10)(P<0.05),但三组间妊娠率无统计学差异(P>0.05)。在D、E、F三组中,E组的正常受精率(69.68%)显著高于D组(61.54%)和F组(54.13%),优胚率(25.27%)显著低于D组(46.81%)和F组(41.03%),差异均有统计学意义(P<0.05),但组间妊娠率无统计学差异(P>0.05)。结论妊娠组自HCG日至胚胎移植日血清E 2浓度均稍高于非妊娠组;取卵日或胚胎移植日相对于HCG日E 2比值的不同并不影响临床妊娠率。Objective:To study the correlation between the changes in the blood estradiol(E 2)levels for 6 consecutive days from the day of HCG injection to the day of cleavage embryo transfer(ET)and pregnancy outcome during the IVF-ET cycle.Methods:The data of 41 infertility patients received IVF-ET treatment in the Reproductive Medicine Center,Maternal&Child Health Hospital of Zibo City from January 2017 to January 2020 were retrospectively analyzed.The patients were divided into pregnant group(n=20)and non-pregnant group(n=21).Serum E 2 levels(d 0E 2,d 1E 2,d 2E 2,d 3E 2,d 4E 2,d 5E 2)were measured for 6 consecutive days from HCG day(d 0),and the differences were compared between the two groups.According to the quartile(P25,P75)of the E 2 ratio of oocyte retrieval day(d 2)to the HCG day(d 2E 2/d 0E 2),they were divided into group A(<P25,n=10),group B(P25-P75,n=21)and group C(>P75,n=10).In addition,according to the quartile(P25,P75)of the E 2 ratio of embryo transfer day(d 5)to HCG day(d 5E 2/d 0E 2),they were divided into group D(<P25,n=10),group E(P25-P75,n=21)and group F(>P75,n=10).The differences of various indicators after ovulation induction were compared among the groups.Results:The E 2 level at each time point in the pregnancy group was higher than the non-pregnancy group,but all the differences were not significant(P>0.05).In the group A,B,C,the number of normal fertilization embryos of group B(8.05±3.09)was significantly higher than of group A(5.20±2.94)and group C(5.60±3.10)(P<0.05),but the difference in pregnancy rate was not significant(P>0.05).Among the group D,E and F,the normal fertilization rate of group E(69.68%)was significantly higher than that of group D(61.54%)and group F(54.13%),and the excellent embryo rate of group E(25.27%)was significantly lower than that of group D(46.81%)and group F(41.03%)(P<0.05),but the difference in pregnancy rate was not significant among the groups(P>0.05).Conclusions:E 2 levels from HCG day to ET day in pregnancy group are higher than those in non-pregnancy group.The

关 键 词：体外受精-胚胎移植 雌激素 孕激素 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]