HCG扳机后血清HCG水平对IVF结局的影响  

Effects of serum HCG level after HCG trigger on IVF outcome

作　　者：吴惠华 孟庆霞[1] 丁洁[1] 王馥新[1] 李红[1] WU Hui-hua;MENG Qing-xia;DING Jie;WANG Fu-xin;LI Hong(Center of Reproduction&Genetics,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215002)

机构地区：[1]南京医科大学附属苏州医院生殖与遗传中心,苏州215002

出　　处：《生殖医学杂志》2021年第3期331-336,共6页Journal of Reproductive Medicine

摘　　要：目的探讨体外受精-胚胎移植(IVF-ET)过程中人绒毛膜促性腺激素(HCG)扳机后12 h的血清HCG水平对IVF结局的影响。方法选择2015年3月至2019年10月于我中心行长方案IVF-ET助孕的854例患者。根据血清HCG水平分为5组:A组:HCG≤58.78 U/L(n=42);B组:58.78 U/L<HCG≤86.80 U/L(n=171);C组:86.80 U/L<HCG≤147.99 U/L(n=428);D组:147.99 U/L<HCG≤222.32 U/L(n=171);E组:HCG>222.32 U/L(n=42)。比较各组的一般基础资料及IVF促排结局。结果从A组到E组,各组患者体重指数(BMI)逐渐下降,HCG日后孕酮(P)水平呈逐渐升高趋势。A组的HCG日后P水平显著低于C、D、E组,B组的HCG日后P水平显著低于D、E组(P<0.005)。获卵率从A组到D组逐渐升高,A组的获卵率显著低于C组和D组,B组的获卵率显著低于D组(P<0.005)。而成熟卵率、受精率、优质胚胎率、临床妊娠率及流产率在各组之间的差异无统计学意义(P>0.05)。回归分析显示,随着BMI及直径≥14 mm卵泡数的增加,HCG日后血HCG水平降低(P<0.05)。获卵率与HCG日后血HCG值呈正相关(P<0.05)。结论BMI是影响HCG扳机后血HCG水平的重要因素。卵巢正常反应患者,HCG日后血HCG水平在达到峰值之前,获卵率随着其水平升高逐渐升高;而当其值达到峰值之后,获卵率不随其水平升高而变化。Objective:To explore the effects of serum HCG level after HCG trigger on the outcomes of IVF-ET.Methods:A total of 854 patients received IVF-ET treatment with GnRH agonist(GnRH-a)protocol from March 2015 to October 2019 were selected.According to the HCG level,the patients were divided into five groups:group A with HCG≤58.78 U/L(n=42),group B with 58.78 U/L<HCG≤86.80 U/L(n=171),group C with 86.80 U/L<HCG≤147.99 U/L(n=428),group D with 147.99 U/L<HCG≤222.32 U/L(n=171),and group E with HCG>222.32 U/L(n=42).The general characteristics and IVF outcomes of each group were analyzed.Results:Body mass index(BMI)declined and progesterone(P)levels increased gradually after HCG day from group A to group E.The P levels on HCG day in group A were significantly lower than those in group C,D&E.The P levels on HCG day in group B were significantly lower than those in group D&E(P<0.005).Oocyte retrieved rate was gradually increased from group A to group D.The oocyte retrieved rate in group A was significantly lower than that in group C&D.The oocyte retrieved rate in group B was significantly lower than that in group D(P<0.005).The mature oocyte rate,fertilization rate,high quality embryo rate,clinical pregnancy rate and abortion rate were not significantly different among these five groups(P>0.05).The regression analysis showed that the serum HCG level decreased after HCG day with the increase of BMI and the number of follicles≥14 mm(P<0.05).There was a positive correlation between the oocyte retrieval rate and the serum HCG level after HCG day(P<0.05).Conclusions:BMI is an important factor affecting the HCG level after HCG trigger.In the patients with normal ovarian response,the oocyte retrieval rate increases gradually with the increase of HCG level before the HCG level reaches the peak,and the oocyte retrieval rate does not change with the increase of HCG level after the HCG level reaches the peak.

关 键 词：HCG水平 获卵率 体外受精-胚胎移植 

分 类 号：R711.6[医药卫生—妇产科学]