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血清雌二醇能否预测 ICSI 周期中卵子和胚胎的质量、卵子成熟度和妊娠率?

Can serum oestradiol be a predictor of quality of oocytes and embryos, maturation of oocytes and pregnancy rate in ICSI cycles?

机构信息

In Vitro Fertilization Clinic, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.

出版信息

Gynecol Endocrinol. 2011 Apr;27(4):279-85. doi: 10.3109/09513590.2010.491168. Epub 2010 Jun 14.

Abstract

Our aim was to assess the influence of ratios of oestradiol (E2) to either number of follicles ≥ 14 mm on the day of human chorionic gonadotropin administration (E2/fol) or the number of oocytes retrieved (E2/o) during oocyte pick up and total serum E2 levels on the day of embryo transfer (ETE2) on the outcome of ICSI cycles. The assessed outcomes were number of oocytes retrieved (NRO), number of mature oocytes (NMO), number of fertilised oocytes (NFO), number of transferred embryos (NTE), qualities of oocytes (OQS), qualities of embryos (EQS) and pregnancy rates (PR). Two hundred and twenty-seven ICSI-ET cycles admitted to our IVF clinic during a 2-year period with normal ovarian reserve receiving long luteal GnRH agonist protocol were included. The E2/fol levels correlated positively with NRO (r = 0.202, p = 0.002), NMO (r = 0.199, p = 0.003) and NFO (r = 0.159, p = 0.018). However, we observed negative correlations between E2/o and NMO (r = -0.329, p <0.001), NFO (r = -0.219, p = 0.001), EQ5 (r = -0.203, p = 0.040). Oocyte quality scores were not affected from either E2/fol or E2/o levels. Implantation, clinical and ongoing PRs were comparable between groups categorised due to E2/fol, E2/o and ETE2. It seems that high E2/fol ratio may have beneficial effects on NRO, NMO and NFO while E2/o may adversely affect these parameters. Neither of the E2 levels is associated with pregnancy rates in women with normal ovarian reserve.

摘要

我们的目的是评估在人绒毛膜促性腺激素(hCG)给药当天取卵时雌二醇(E2)与≥14mm 的卵泡数(E2/fol)或取卵时的总血清 E2 水平(ETE2)与卵母细胞回收数(NRO)、成熟卵母细胞数(NMO)、受精卵母细胞数(NFO)、移植胚胎数(NTE)、卵母细胞质量(OQS)、胚胎质量(EQS)和妊娠率(PR)之间的关系。在接受长黄体期 GnRH 激动剂方案的正常卵巢储备接受者的 2 年期间,我们对 227 个 ICSI-ET 周期进行了评估。E2/fol 水平与 NRO(r = 0.202,p = 0.002)、NMO(r = 0.199,p = 0.003)和 NFO(r = 0.159,p = 0.018)呈正相关。然而,我们观察到 E2/o 与 NMO(r = -0.329,p <0.001)、NFO(r = -0.219,p = 0.001)和 EQS(r = -0.203,p = 0.040)呈负相关。E2/fol 或 E2/o 水平均不影响卵母细胞质量评分。根据 E2/fol、E2/o 和 ETE2 进行分组后,胚胎着床率、临床妊娠率和持续妊娠率无差异。高 E2/fol 比值可能对 NRO、NMO 和 NFO 有益,而 E2/o 可能对这些参数产生不利影响。在具有正常卵巢储备的女性中,E2 水平均与妊娠率无关。

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