泌乳素血清基础水平及卵巢刺激后增幅对长方案IVF/ICSI助孕结局的影响  

Effects of serum prolactin levels at basal and stimulated status on outcomes of patients undergoing in vitro fertilization/intracytoplasmic sperm injection in gonadotropin agonist long protocol

作　　者：张多多 甄璟然 郁琦 Zhang Duoduo;Zhen Jingran;Yu Qi(National Clinical Research Center for Obstetrics&Gynecologic Disease,Center for Gynecological Endocrinology&Reproductive Medicine,Chinese Academy of Medical Science,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]国家妇产疾病临床医学研究中心,中国医学科学院北京协和医院妇科内分泌与生殖中心,北京100730

出　　处：《中华生殖与避孕杂志》2022年第2期150-155,共6页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨外源性促性腺激素促排卵过程中,血清泌乳素水平高低对体外受精/卵胞质内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)助孕结局的影响。方法采用回顾性队列研究,分析2014年7月1日至2018年3月31日期间在北京协和医院妇科内分泌与生殖中心因输卵管或男方因素行IVF/ICSI治疗的3009例患者的临床资料。根据纳入患者的基础泌乳素水平的中位值(16.05μg/L)进行分组后,比较患者的辅助生殖结局,并且根据不同的基础泌乳素水平进行多因素亚组分析。采用重复测量的方差分析方法分析促排卵过程中不同时间点泌乳素的增长趋势与对应周期累积妊娠结局的关系。结果基础泌乳素水平>16.05μg/L的患者比≤16.05μg/L患者有更多的获卵数[9(5,12)枚比8(5,11)枚,P=0.013)及胚胎数[6(3,10)枚比5(3,9)枚,P=0.015]。基础泌乳素>30μg/L有利于累积妊娠(OR=1.281,95%CI=1.030~1.764,P=0.046),而>40μg/L有利于累积活产(OR=1.916,95%CI=1.115~3.290,P=0.008)。结论对于长方案促排卵的IVF/ICSI人群,更高的泌乳素水平与更好的累积妊娠或活产结局相关。Objective To determine whether basal prolactin levels impact pregnancy outcomes of the patients who underwent in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)procedures rely on endogenous gonadotropin.Methods This retrospective cohort study finally included 3009 patients from July 1st,2014 to March 31st,2018 receiving IVF/ICSI cycles owing to tubal or male factors in Center for Gynecological Endocrinology&Reproductive Medicine,Peking Union Medical College Hospital.We compared assisted reproductive outcomes among patients according to their median prolactin levels(16.05μg/L).Subgroup analyses divided by different prolactin levels were done through multifactor analyses.A repeated analysis of variance was used to illustrate the relationship between the scale of prolactin grows while stimulating and cumulative pregnancy outcomes.Results There were more number of oocytes retrieved[9(5,12)]and embryos[6(3,10)]in those with basal prolactin above the median level(>16.05μg/L)compared with patients with basal prolactin≤16.05μg/L[8(5,11),P=0.013;5(3,9),P=0.015].Prolactin beyond 30μg/L was beneficial to cumulative clinical pregnancy(OR=1.281,95%CI=1.030-1.764,P=0.046)and prolactin above 40μg/L was a good indication for cumulative live birth rate(OR=1.916,95%CI=1.115-3.290,P=0.008).Conclusion For patients receiving IVF/ICSI treatment in an agonist long protocol,a higher prolactin level during controlled ovarian stimulation is positively associated with cumulative pregnancy/live birth rates.

关 键 词：泌乳素 受精 体外 单精子注射 细胞质内 临床妊娠率 活产率 

分 类 号：R714[医药卫生—妇产科学]