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在使用长效促性腺激素释放激素激动剂方案治疗的卵巢储备功能正常的女性中,人绒毛膜促性腺激素给药当天血清孕酮与雌二醇比值升高对临床妊娠率没有负面影响。

An increased serum progesterone-to-estradiol ratio on the day of human chorionic gonadotropin administration does not have a negative impact on clinical pregnancy rate in women with normal ovarian reserve treated with a long gonadotropin releasing hormone agonist protocol.

作者信息

Lai Tsung-Hsuan, Lee Fa-Kung, Lin Tseng-Kai, Horng Shang-Gwo, Chen Su-Chee, Chen Ya-Hui, Wang Pa-Chun

机构信息

Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan.

出版信息

Fertil Steril. 2009 Aug;92(2):508-14. doi: 10.1016/j.fertnstert.2008.06.036. Epub 2008 Aug 12.

Abstract

OBJECTIVE

To evaluate the relationship between serum P:E(2) ratio on the day of hCG administration and the clinical outcomes in infertile women with normal ovarian reserve treated with a long GnRH agonist (GnRH-a) protocol.

DESIGN

Retrospective analysis of IVF-embryo transfer data.

SETTING

University teaching hospital.

PATIENT(S): One hundred thirty-nine infertile women with normal ovarian reserve, who received IVF-embryo transfer with a long GnRH-a protocol.

INTERVENTION(S): Cycles were grouped according to whether premature luteinization (PL) appeared on the day of hCG administration. Premature luteinization was defined as a P:E(2) ratio >or=1.2 by using receiver operator characteristic analysis.

MAIN OUTCOME MEASURE(S): Treatment cycle hormonal characteristics and clinical outcomes.

RESULT(S): The P:E(2) ratio on the day of hCG administration was significantly higher in the PL (n = 41) compared with the non-PL (n = 98) group (2.4 +/- 1.5 and 0.6 +/- 0.3, respectively). The mean number of oocytes retrieved in the PL and non-PL groups were 4.2 +/- 2.8 and 12.7 +/- 6.6, respectively. However, the difference between the clinical pregnancy rates (PR) in the PL and non-PL groups was not statistically significant (29.3% vs. 34.5%). In a logistic regression analysis, the P:E(2) ratio showed no statistically significant correlation with pregnancy outcome.

CONCLUSION(S): The increased serum P:E(2) ratio on the day of hCG administration, as an indicator of PL, has a poor predictive value on IVF outcomes in infertile women with normal ovarian reserve treated with a long GnRH-a protocol.

摘要

目的

评估在接受长效促性腺激素释放激素激动剂(GnRH-a)方案治疗的卵巢储备功能正常的不孕女性中,注射人绒毛膜促性腺激素(hCG)当天血清孕酮与雌二醇比值(P:E2)与临床结局之间的关系。

设计

对体外受精-胚胎移植数据进行回顾性分析。

地点

大学教学医院。

患者

139例卵巢储备功能正常的不孕女性,她们接受了长效GnRH-a方案的体外受精-胚胎移植。

干预措施

根据hCG注射当天是否出现过早黄素化(PL)对周期进行分组。通过受试者工作特征分析,将过早黄素化定义为P:E2比值≥1.2。

主要观察指标

治疗周期的激素特征和临床结局。

结果

与未出现过早黄素化(n = 98)的组相比,出现过早黄素化(n = 41)的组在hCG注射当天的P:E2比值显著更高(分别为2.4±1.5和0.6±0.3)。过早黄素化组和未出现过早黄素化组回收的卵母细胞平均数量分别为4.2±2.8和12.7±6.6。然而,过早黄素化组和未出现过早黄素化组的临床妊娠率(PR)差异无统计学意义(29.3%对34.5%)。在逻辑回归分析中,P:E2比值与妊娠结局无统计学显著相关性。

结论

在接受长效GnRH-a方案治疗的卵巢储备功能正常的不孕女性中,hCG注射当天血清P:E2比值升高作为过早黄素化的指标,对体外受精结局的预测价值较差。

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