超排卵后黄体期血雌孕激素水平对胚胎着床的影响  

The Influence of the Estrogens and Progestogen on Embryo Nidation in Luteal Phase After Superovulation

作　　者：陆秀娥[1] 吴丽萍[1] 周馥贞[1] 

机构地区：[1]浙江大学医学院附属妇产科医院,浙江杭州310006

出　　处：《浙江预防医学》2004年第5期9-10,共2页Zhejiang Journal of Preventive Medicine

摘　　要：目的　测定控制下超排卵周期黄体期血雌二醇 (E2 )和孕酮 (P)水平 ,探讨黄体期甾体激素对体外受精—胚胎移植 (IVF ET)结局的影响。方法　选择在本院辅助生育技术病房进行IVF—ET助孕治疗的因输卵管因素不孕的 64例患者 ,用GnRHa (达必佳 ) /FSH/hMG/hCG超排卵治疗 ,在注hCG日及取卵后 7天采集静脉血 5ml,用双抗放射免疫法 (RIA)测定血清雌二醇 (E2 )和孕酮 (P)。结果　未妊娠组高反应组与正常反应组获卵数存在显著差异 (P <0 0 5 ) ,年龄、获卵数、移植胚胎数两组无显著差异 (P >0 0 5 )。继续妊娠组与流产组E2 峰、黄体中期E2 、P水平及P/E2 比均无显著差异 (P >0 0 5 ) ,继续妊娠组E2 从峰值下降至黄体中期水平与流产组相比 ,存在显著差异 (P <0 0 5 ) ,继续妊娠组E2 下降幅度大 ;未孕高反应组E2峰、黄体中期E2 、P水平与继续妊娠组相比均显著增高 (P <0 0 5 ) ,但P/E2 比无显著差异 ,未孕正常反应组各激素水平及比与继续妊娠组相比无显著差异 (P >0 0 5 )。结论　超排卵治疗后黄体期雌孕激素对妊娠的影响与卵巢反应有关 ,高反应组黄体中期过高的雌孕激素不利于妊娠 ,正常反应组黄体中期雌孕激素水平与妊娠无关。E2 从峰值至黄体中期水平下降幅度与妊娠有关 ,E2 缺乏下降也许对妊娠不利?Objective To explore the influence of the steroid hormone level on in vitro fertilization-embryo transfer (IVF-ET) in luteal phase after superorulation. Methods 64 patients undergoing IVF were identified and treated with GnRHa, FSH, hMG and hCG. The level of the Estradiol and progesteron were detected with Radioimmunoassay (RIA) after injected with hCG and 7 days after superovulation. Results The number of ovary between non-pregnancy group and normal group had statistical difference(P<0 05), but the age and the number of embryo transfer did not have statistical difference(P>0.05). The peak of Estradiol, Estradiol level in luteal, progesteron level and the ratio of progesterone over Estradiol between pregnancy group and abortion group had no statistical difference(P>0 05), but the descent range of the Estradiol in abortion group was significantly lower than in the pregnancy. The peak of Estradiol, Estradiol level in luteal, progesteron level in non-pregnancy group had a significant increase compared to abortion group (P<0 05), the ratio of progesterone over Estradiol had no statistically significance. The level of steroid hormone between normal group and pregnancy group had no significant difference (P>0 05). Conclusions The influence of estrogen and progestogen on pregnancy in luteal after superovulation are correlated with the condition of ovary. The high level of the estrogen and progestogen in pregnancy group has some influence on pregnancy, but there has no influence in the control group. The descent range of the Estradiol in luteal has some correlation with pregnancy, and the lack of the Estradiol may damage the pregnancy.

关 键 词：超排卵后黄体期 雌孕激素 胚胎着床 妊娠 孕酮 

分 类 号：R321.3[医药卫生—人体解剖和组织胚胎学]