HCG日孕酮水平对早卵泡期长效长方案IVF/ICSI临床结局的影响  

Effect of progesterone level on HCG day on clinical pregnancy outcome of IVF/ICSI of the long-acting GnRH agonist long protocol during early follicular phase

作　　者：杨如雪 李丹阳 刘洋 管一春[1] 孙丽君[1] Yang Ruxue;Li Danyang;Liu Yang(Reproductive Center of the Third Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第三附属医院生殖医学科,郑州450000

出　　处：《现代妇产科进展》2022年第8期605-609,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨早卵泡期长效长方案IVF/ICSI新鲜胚胎移植周期中,HCG日血清孕酮(P)水平对临床结局的影响。方法:采用回顾性队列研究,分析2015年8月至2020年6月在郑州大学第三附属医院生殖医学中心采用早卵泡期长效长方案促排卵行IVF/ICSI新鲜胚胎移植周期的临床资料,共5023周期。根据HCG日P水平分为四组,A组:P<1ng/mL(2275周期)、B组:1ng/mL≤P<1.5ng/mL(1744周期)、C组1.5ng/mL≤P<1.75ng/mL(271周期)及D组:1.75ng/mL≤P<3ng/mL(733周期)。通过单因素方差分析与卡方检验比较4组的一般资料、临床促排情况、胚胎实验室指标、临床妊娠率及活产率,采用logistic/线性回归校正混杂因素,分析HCG日P水平对临床结局的影响。结果:经回归校正混杂因素后,4组囊胚形成率差异无统计学意义(P>0.05);A、B组的着床率显著高于D组(P<0.05);A组的临床妊娠率高于B、C组及D组,B组的临床妊娠率高于D组(P均<0.05);A组的活产率高于C、D组,B组的活产率高于D组(P均<0.01)。4组的中重度卵巢过度刺激综合征(OHSS)发生率、异位妊娠率及早期流产率比较,差异无统计学意义(P>0.05)。结论:HCG日血清P升高不会影响IVF/ICSI中卵母细胞及胚胎质量;HCG日P<1ng/mL时,新鲜胚胎移植周期的临床妊娠率与活产率最高。Objective:To investigate the effect of serum progesterone(P)level of the HCG trigger day on the clinical pregnancy outcome in long-acting GnRH agonist long protocol during early follicular phase.Methods:It was a retrospective cohort study.A total of 5023 fresh embryo transfer cycles in the reproductive medicine center of the third Affiliated Hospital of Zhengzhou University from August 2015 to June 2020,which used a long-acting GnRH agonist long protocol during early follicular phase,were included.According to the daily P level of HCG,all cycles divided into four groups,group A:P≤1 ng/mL(n=2,275),group B:1 ng/mL≤P<1.5 ng/mL(n=1,744),group C:1.5 ng/mL≤P<1.75 ng/mL(n=271),group D:1.75 ng/mL≤P<3 ng/mL(n=733).The effect of P level on HCG day on clinical pregnancy outcome was analyzed by one-way analysis of variance(ANOVA)and binary Logistic regression model.Results:After regression and correction of confounding factors,there was no significant difference in the blastocyst formation rate among the four groups(P>0.05).The implantation rate of groups A and B was significantly higher than that of group D(P<0.05).The clinical pregnancy rate of group A was higher than that of groups B,C and D,and the clinical pregnancy rate of group B was higher than that of group D(P<0.05).The live birth rate of group A was higher than that of groups C and D,and the live birth rate of group B was higher than that of group D(all P<0.01).There were no significant differences in the incidence of moderate to severe OHSS,ectopic pregnancy and early miscarriage among the groups(P>0.05).Conclusions:The increase of serum progesterone on HCG day did not affect the quality of oocytes and embryos.When P<1 ng/mL on HCG day,the clinical pregnancy rate and live birth rate of the fresh embryo transfer cycle were the highest.

关 键 词：HCG日孕酮 临床妊娠结局 早卵泡期长效长方案 

分 类 号：R711.6[医药卫生—妇产科学]