Peña Joseph E, Chang Peter L, Chan Lai-King, Zeitoun Khaled, Thornton Melvin H, Sauer Mark V
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, College of Physicians & Surgeons, Columbia University, New York, New York 10032, USA.
Hum Reprod. 2002 Jan;17(1):83-7. doi: 10.1093/humrep/17.1.83.
The study aim was to determine whether supraphysiological estradiol (E(2)) levels reduce oocyte/embryo quality in oocyte donation cycles.
A retrospective analysis of 330 consecutive fresh oocyte donation cycles was performed in an assisted reproductive treatment programme between January 1996 and December 2000. Throughout the study period, oocyte donors and recipients followed a standard synchronization regimen that did not vary. A serum E(2) level (peak E(2)) was obtained from all oocyte donors on the morning of HCG administration. Peak E(2) values were grouped by 33rd percentile (group I, <1500 pg/ml; group II, 1500-3000 pg/ml; and group III, >3000 pg/ml). All embryo transfers were performed on day 3 after oocyte recovery.
Comparisons between groups revealed no significant differences in the quality of oocytes retrieved, and in fertilization rates. Higher peak E(2) levels were directly correlated with a greater number of oocytes retrieved, embryos available for transfer and cryopreservation, and higher average embryo quality scores (P < 0.005). Compared with group I, group III had significantly higher embryo implantation rates (P < 0.05).
Sustained supraphysiological E(2) levels do not adversely affect the quality of developing oocytes and embryos. On the contrary, elevated E(2) levels are associated with a larger number of oocytes and embryos and high-grade embryos for transfer/cryopreservation and, consequently, improved implantation rates.
本研究旨在确定超生理水平的雌二醇（E₂）是否会降低卵母细胞捐赠周期中卵母细胞/胚胎的质量。
对1996年1月至2000年12月在一个辅助生殖治疗项目中连续进行的330个新鲜卵母细胞捐赠周期进行回顾性分析。在整个研究期间，卵母细胞捐赠者和接受者遵循不变的标准同步方案。在注射人绒毛膜促性腺激素（HCG）当天早晨，从所有卵母细胞捐赠者处获取血清E₂水平（E₂峰值）。E₂峰值按第33百分位数分组（I组，<1500 pg/ml；II组，1500 - 3000 pg/ml；III组，>3000 pg/ml）。所有胚胎移植均在卵母细胞回收后第3天进行。
组间比较显示，所获卵母细胞质量和受精率无显著差异。较高的E₂峰值水平与所获卵母细胞数量、可用于移植和冷冻保存的胚胎数量以及较高的平均胚胎质量评分直接相关（P < 0.005）。与I组相比，III组的胚胎着床率显著更高（P < 0.05）。
持续的超生理E₂水平不会对发育中的卵母细胞和胚胎质量产生不利影响。相反，E₂水平升高与更多数量的卵母细胞和胚胎以及用于移植/冷冻保存的高质量胚胎相关，从而提高着床率。
