Forman R G, Robinson J, Egan D, Ross C, Gosden B, Barlow D H
Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
Fertil Steril. 1991 Mar;55(3):567-73. doi: 10.1016/s0015-0282(16)54187-9.
Previous investigations of in vitro fertilization (IVF) cycles stimulated with gonadotropins have shown that it is possible to predict IVF outcome on the basis of the pattern of estradiol (E2) production in the terminal phase of follicular growth. This analysis looked at endocrine and ultrasound parameters in the late follicular phase of 320 patients in their first cycle of IVF. All cycles were stimulated by an association of gonadotropin-releasing hormone agonists (GnRH-a) and human menopausal gonadotropins (hMG). The pregnancy rate (PR) was not related to the E2 pattern in the 5 days before ovulation induction and was 33% and 39% even when E2 values fell during hMG administration. The PR was independent of the E2 level and the number of follicles greater than 14 mm on the day of human chorionic gonadotropin administration (day 0). The incidence of multiple pregnancy increased when E2 levels were greater than 1,000 pg/mL. It is concluded that follicular phase parameters used for cycle cancellation in hMG-stimulated IVF cycles cannot be extrapolated to GnRH-a/hMG cycles.
以往对用促性腺激素刺激的体外受精（IVF）周期的研究表明，根据卵泡生长末期雌二醇（E2）的产生模式来预测IVF结局是可行的。本分析观察了320例首次接受IVF周期治疗患者卵泡晚期的内分泌和超声参数。所有周期均采用促性腺激素释放激素激动剂（GnRH-a）与人绝经期促性腺激素（hMG）联合刺激。妊娠率（PR）与诱导排卵前5天的E2模式无关，即使在hMG给药期间E2值下降，妊娠率也分别为33%和39%。PR与E2水平以及人绒毛膜促性腺激素给药当天（第0天）直径大于14 mm的卵泡数量无关。当E2水平大于1000 pg/mL时，多胎妊娠的发生率增加。得出的结论是，在hMG刺激的IVF周期中用于取消周期的卵泡期参数不能外推至GnRH-a/hMG周期。
