Rapi S, Fuzzi B, Mannelli M, Pratesi S, Criscuoli L, Pellegrini S, Messeri G
Gynaecologic and Obstetric Department, University of Florence.
Acta Eur Fertil. 1992 Mar-Apr;23(2):63-8.
Many works in the literature of the last years had reported that urinary approach to superovulation study is a suitable method to evaluate ovarian response to pharmacological stimulation. Before applying urinary determination of hormonal levels with a chemiluminescence immuno assay (LIA) method in early morning urine (EMU) samples, we had studied the correlation of RIA-LIA procedures with reference to follicular volumes at hCG day and to recovered oocyte maturity; in fact follicular growth and oocyte morphological features are the main parameters to evaluate a successful induced cycle. In our department the IVF cycles are daily monitored with RIA seric E2 and LIA E1-3G determination, besides ultrasound examination of follicular growth. We have studied E2 and E1-3G levels on the hCG administration day and their correlation with follicular areas and volumes; moreover, we have evaluated hormonal values on oocyte pick-up day with reference to recovered oocyte number and maturity. We have assumed as good timing for oocyte pick-up when more than 50% of recovered oocytes were of good quality (maturity score 4). We have observed that the highest pre ovulatory E1-3G value is consistent with the best timing for oocyte pick-up; it's possible to obtain a conversion coefficient follicular volumes and urinary E1-3G excretion. We have not found significant differences between plasmatic and urinary estrogenic parameters. It is important to remember the advantages connected by a not isotopic and not invasive method. The absence of discomfort for the patients may be a decisive factor to choose the monitoring method and LIA procedure may represent a valid alternative to RIA.
近年来的许多文献报道称，采用尿液途径进行超排卵研究是评估卵巢对药物刺激反应的一种合适方法。在采用化学发光免疫分析（LIA）方法对清晨尿液（EMU）样本进行激素水平的尿液检测之前，我们研究了放射免疫分析（RIA）-LIA程序与hCG日卵泡体积以及回收卵母细胞成熟度之间的相关性；事实上，卵泡生长和卵母细胞形态特征是评估诱导周期成功与否的主要参数。在我们科室，除了对卵泡生长进行超声检查外，还通过RIA血清E2和LIA E1-3G检测对IVF周期进行每日监测。我们研究了hCG给药日的E2和E1-3G水平及其与卵泡面积和体积的相关性；此外，我们参照回收的卵母细胞数量和成熟度评估了取卵日的激素值。当超过50%的回收卵母细胞质量良好（成熟度评分4）时，我们认为这是取卵的最佳时机。我们观察到，排卵前E1-3G的最高值与取卵的最佳时机一致；可以获得卵泡体积与尿液E1-3G排泄量的转换系数。我们未发现血浆和尿液雌激素参数之间存在显著差异。必须牢记非同位素和非侵入性方法所带来的优势。患者没有不适感可能是选择监测方法的一个决定性因素，而LIA程序可能是RIA的一种有效替代方法。
