Alam V, Altieri E, Zegers-Hochschild F
Unidad de Medicina Reproductiva, Clínica Las Nieves, Santiago , Chile.
Hum Reprod. 1999 Sep;14(9):2375-8. doi: 10.1093/humrep/14.9.2375.
The precise mechanisms by which corpus luteum (CL) function is modulated during early pregnancy are not known. Evidence in failed pregnancies (ectopic, abortions), shows that factors other than human chorionic gonadotrophin (HCG) could be involved in its regulation. The objective of this study was to investigate the dynamics of beta-HCG, progesterone and oestradiol production in early pregnancy and its relation to embryonic quality and topographic localization. Plasma concentrations of progesterone, oestradiol and beta-HCG were studied between days +12 and +21 after an in-vitro fertilization (IVF) embryo transfer in 11 intrauterine pregnancies, 10 intrauterine abortions and seven tubal pregnancies. Tubal pregnancies and abortions were grouped according to doubling time (DT) of HCG. Results showed that oestradiol concentrations were apparently reduced in both ectopic pregnancies and abortions compared with normal pregnancies. The fall in oestradiol concentrations was seen in ectopic pregnancies with an abnormal DT for HCG and in all abortions. When the ectopic pregnancy had a normal DT, oestradiol and progesterone concentrations were normal. In abortions, the fall in oestradiol and progesterone concentrations was less influenced by the DT of HCG. These findings suggest that corpus luteum function depends on an adequate DT of HCG more than an absolute value, and with normal trophoblastic tissue the site of implantation does not affect CL function.
在妊娠早期调节黄体(CL)功能的精确机制尚不清楚。在妊娠失败(异位妊娠、流产)的病例中,有证据表明,除人绒毛膜促性腺激素(HCG)外,其他因素可能参与其调节。本研究的目的是调查妊娠早期β-HCG、孕酮和雌二醇产生的动态变化及其与胚胎质量和着床部位的关系。在11例宫内妊娠、10例宫内流产和7例输卵管妊娠的体外受精(IVF)胚胎移植后第12天至第21天期间,研究了血浆中孕酮、雌二醇和β-HCG的浓度。输卵管妊娠和流产根据HCG的倍增时间(DT)进行分组。结果显示,与正常妊娠相比,异位妊娠和流产中的雌二醇浓度明显降低。在HCG的DT异常的异位妊娠和所有流产中均观察到雌二醇浓度下降。当异位妊娠的DT正常时,雌二醇和孕酮浓度正常。在流产中,雌二醇和孕酮浓度的下降受HCG的DT影响较小。这些发现表明,黄体功能更多地取决于HCG的适当DT,而非绝对值,并且在滋养层组织正常的情况下,着床部位不影响黄体功能。