Ni Hao, Chen Lei-ning, Quan Song, Li Hong, Hua Rui, Gao Rui-hua, Chen Si-mei, Luo Chen
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2011 Feb;31(2):365-8.
To investigate the value of serum estradiol increment and serum estradiol/follicles on the day of hCG administration in predicting the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET).
A retrospective analysis of the IVF-ET data was conducted involving 121 patients who received a long gonadotrophin-releasing hormone agonist (GnRHa) protocol. According to the increment of serum estradiol on the day of hCG administration (relative to the level on the day before hCG administration), the patients were divided into 3 groups (A1, A2 and A3) with a increment ratio below 30%, between 30% and 50%, and over 50%, respectively. In addition, according to the ratio of serum estradiol level on hCG day to mature follicle (diameter ≥ 14 mm) number, these patients were divided into three groups (B1, B2 and B3) with the ratio below 250 pg/ml, between 250 and 350 gp/ml, and over 350 pg/ml, respectively. The hormonal characteristics and clinical outcomes of the IVF-ET cycles were analyzed comparatively.
Both the clinical pregnancy rate (71.05%) and embryo implantation rate (52.63%) were significantly higher in group A3 than in groups A1 and A2 (P<0.05). The best clinical pregnancy rate (67.86%) and embryo implantation rate (49.14%) were significantly higher in group B2 than in groups B1 and B3 (P<0.05).
The variation of serum estradiol shows an important impact on the clinical outcomes of IVF-ET in patients receiving long GnRH-a protocol. Favorable outcomes can be expected with a hCG day serum estradiol increment ratio above 50% and E(2)/follicle ratio between 250 and 350 pg/ml.
探讨人绒毛膜促性腺激素（hCG）注射日血清雌二醇增加值及血清雌二醇/卵泡数对体外受精-胚胎移植（IVF-ET）临床结局的预测价值。
对121例行长效促性腺激素释放激素激动剂（GnRHa）方案的IVF-ET患者资料进行回顾性分析。根据hCG注射日血清雌二醇增加值（相对于hCG注射前一日水平），将患者分为3组（A1、A2和A3组），增加值比例分别低于30%、30%至50%、高于50%。此外，根据hCG日血清雌二醇水平与成熟卵泡（直径≥14mm）数的比值，将这些患者分为3组（B1、B2和B3组），比值分别低于250pg/ml、250至350pg/ml、高于350pg/ml。对IVF-ET周期的激素特征和临床结局进行比较分析。
A3组的临床妊娠率（71.05%）和胚胎着床率（52.63%）显著高于A1组和A2组（P<0.05）。B2组的最佳临床妊娠率（67.86%）和胚胎着床率（49.14%）显著高于B1组和B3组（P<0.05）。
血清雌二醇的变化对接受长效GnRHa方案的IVF-ET患者的临床结局有重要影响。hCG日血清雌二醇增加值比例高于50%且E(2)/卵泡比值在250至350pg/ml之间时，有望获得良好结局。
