控制性超排卵中血清孕酮浓度升高对体外受精-胚胎移植的影响  

The Effect of Increased Serum Progesterone Level in Controlled Ovarian Hyperstimulation on in Vitro Fertilization-embryo Transfer

作　　者：叶虹[1] 黄国宁[1] 裴莉[1] 刘红[1] 刘东云[1] 

机构地区：[1]重庆市妇产科医院重庆市生殖与遗传研究所,重庆400013

出　　处：《实用妇产科杂志》2003年第5期285-287,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的 :探讨控制性超排卵 (COH)卵泡发育晚期血清孕酮浓度升高对体外受精 胚胎移植 (IVF ET)的影响。方法 :将 2 0 0 0年 1月至 2 0 0 1年 12月在本所接受IVF或卵细胞浆单精子显微注射 (ICSI)助孕的不孕症患者 5 41例 ,依注射绒毛膜促性腺激素 (HCG)日血清孕酮浓度的不同分为 4组 :1组 ,血清孕酮≤ 2 .86nmol/L者 198例 ;2组 ,血清孕酮 >2 .86～ <6 .36nmol/L者 2 0 9例 ;3组 ,血清孕酮≥ 6 .36～ <9.5 4nmol/L者 81例 ;4组 ,血清孕酮≥ 9.5 4nmol/L者 5 3例 ,回顾性地分析IVF/ICSI结局。结果 :第 4组种植率 (5 .2 3%)和临床妊娠率 (13.2 1%)明显低于其他组 (P <0 .0 1、P <0 .0 5 ) ,流产率 (5 7.14%)呈增高趋势 ,而HCG日血清雌二醇 (E2 )、黄体生成素 (LH)、平均获卵数、第 2次成熟分裂中期卵子数、受精率、卵裂率、优质胚胎形成率 ,4组之间差异无显著性。结论 :在COH卵泡发育晚期血清孕酮浓度≥ 9.5 4nmol/L ,IVF ET后胚胎种植率和临床妊娠率下降 ,流产率增加。Objective :To study the effect of increased serum progesterone (serum P) level in the late follicular phase of controlled ovarian hyperstimulation (COH) on in vitro fertilization-embryo transfer (IVF-ET). Methods: Five hundred and forty-one infertile couples that accepted at least one IVF and/or intracytoplasmic sperm injection (ICSI) treatment cycles were evaluated retrospectively in this study. They were divided into four groups according to serum P level on the day of human chorionic gonadotropin (HCG) injection: group one (serum P≤2.86 nmol/L, 198 cases),group two (serum P>2.86 nmol/L and <6.36 nmol/L, 209 cases),group three (serum P≥6.36 nmol/L and <9.54 nmol/L, 81 cases) and group four (serum P≥9.54 nmol/L, 53 cases). Results: The implantation rates (5.23%) and clinical pregnancy rates (13.21%) in group four were significant lower than other groups (P<0.01, P<0.05, respectively). A rising trend in spontaneous abortion rate were observed in group four(57.14%). There were no statistically differences in the level of serum estradiol (E 2) and luteinizing hormone (LH) on the day of HCG,the number of oocytes retrieved?metaphase of second meiosis oocytes ?fertilization rates ,embryos cleavage rates and high quality embryos rates among four groups. Conclusions: The implantation rates and clinical pregnancy rates decreased and the spontaneous abortion rates increased in IVF-ET in the cases of the serum P level≥9.54 nmol/L in the late follicular phase in controlled ovarian stimulation.

关 键 词：控制性超排卵 血清孕酮 浓度 体外受精 胚胎移植 影响 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]