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重组人促黄体生成素在体外受精-胚胎移植中用于促排卵的应用

[Use of recombinant human luteinizing hormone for ovulation stimulation in in vitro fertilization-embryo transfer].

作者信息

Xu Shi-ru, Li Yuan, Liu Hong, Li Hai-yan, Tang Rong, Gao Qin, Sheng Yan, Chen Zi-Jiang

机构信息

Reproductive Medical Center, Provincial Hospital Affiliated to Shandong University, Jinan, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2010 Jun;45(6):420-3.

Abstract

OBJECTIVE

To evaluate application of recombinant human luteinizing hormone (r-hLH) used in ovarian stimulation of assisted reproductive technique and impact on outcome of pregnancy.

METHODS

From Apr. to Jul. 2009, 123 patients with low LH level (< 1 U/L) at day 3 of menstruation and down-regulation of pituitary function undergoing in vitro fertilization-embryo transfer (IVF-ET) in Reproductive Medical Center, Provincial Hospital Affiliated to Shandong University were enrolled in this study, whom were classified into 66 cases treated by r-hLH in r-hLH group and 57 cases without r-hLH treatment in non-r-hLH group. In the mean time, 145 patients with normal level of serum LH (1 - 2 U/L) not given by r-hLH treatment and undergoing IVF-ET were matched as control group. Total amount of gonadotropin, estradiol levels and LH levels on the administration of human chorionic gonadotropin (hCG), number of oocytes retrieved, number of 2PN zygotes, rate of high quality embryos, the rates of implantation and clinical pregnancy were compared among these three groups.

RESULTS

The level of serum LH on the day of hCG administration were (1.59 ± 0.77) U/L in r-hLH group, (0.54 ± 0.25) U/L in non-r-hLH group and (2.39 ± 1.01) U/L in control group, which reached statistical difference between every two groups (P < 0.05). The rates of high quality embryo were 59.36% in r-hLH group, 57.79% in non-r-hLH group, which were significantly lower than 65.94% in control group, respectively (P < 0.05). The rates of 2PN were 67.62% in r-hLH group and 68.32% in control group, which were significantly higher than 62.84% in non-r-hLH group, respectively (P < 0.05). The rates of implantation of 29.77% in r-hLH group were significantly higher than 18.26% in non-r-hLH group (P < 0.05). The total amount of gonadotropin, estradiol level on the day of hCG administration, the number of oocytes retrieved, and clinical pregnancy rate were not significantly different among those three groups (P > 0.05).

CONCLUSION

The administration of recombinant human luteinizing hormone in patients who are profoundly suppressed after down-regulation with long protocol can get more quality embryos, the higher rates of 2PN and implantation.

摘要

目的

评估重组人促黄体生成素(r-hLH)在辅助生殖技术卵巢刺激中的应用及其对妊娠结局的影响。

方法

选取2009年4月至7月在山东大学附属省立医院生殖医学中心接受体外受精-胚胎移植(IVF-ET)且月经第3天促黄体生成素(LH)水平低(<1 U/L)及垂体功能被下调的123例患者,分为r-hLH组66例,接受r-hLH治疗;非r-hLH组57例,未接受r-hLH治疗。同时,选取145例血清LH水平正常(1 - 2 U/L)且未接受r-hLH治疗并接受IVF-ET的患者作为对照组。比较三组患者人绒毛膜促性腺激素(hCG)注射日的促性腺激素总量、雌二醇水平及LH水平、获卵数、2PN受精卵数、优质胚胎率、着床率及临床妊娠率。

结果

hCG注射日血清LH水平,r-hLH组为(1.59±0.77)U/L,非r-hLH组为(0.54±0.25)U/L,对照组为(2.39±1.01)U/L,两两比较差异均有统计学意义(P<0.05)。优质胚胎率,r-hLH组为59.36%,非r-hLH组为57.79%,均显著低于对照组的65.94%(P<0.05)。2PN率,r-hLH组为67.62%,对照组为68.32%,均显著高于非r-hLH组的62.84%(P<0.05)。r-hLH组着床率为29.77%,显著高于非r-hLH组的18.26%(P<0.05)。三组患者促性腺激素总量、hCG注射日雌二醇水平、获卵数及临床妊娠率比较,差异均无统计学意义(P>0.05)。

结论

对于采用长方案降调节后被深度抑制的患者,应用重组人促黄体生成素可获得更多优质胚胎、更高的2PN率及着床率。

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