Hutchinson-Williams K A, DeCherney A H, Lavy G, Diamond M P, Naftolin F, Lunenfeld B
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510.
Fertil Steril. 1990 Mar;53(3):495-501.
The luteal phase hormone profiles of two groups participating in the Yale in vitro fertilization (IVF) program were compared. A control group (group I) consisted of 28 women (28 cycles) who received our standard ovulation induction regimen (no luteal phase support). The treatment group (group II) consisted of 40 women (42 cycles) who were prospectively studied after receiving luteal phase support with 10,000 IU human chorionic gonadotropin (hCG) 5 days after the initial hCG dose. The groups were matched for age and cause of infertility. Estradiol (E2) and progesterone (P) were measured on the day of embryo transfer and every 3 to 4 days thereafter. Luteal phase hCG support significantly augmented (1) E2 and P levels in the conception cycles of group II compared with group I and (2) P levels in the nonconception cycles of group II compared with group I. The midluteal decline in E2 and P that was observed in group I was minimized or prevented in group II. An ongoing pregnancy rate of 19% was achieved in group II. This was not statistically different from the 13% ongoing pregnancy rate noted in a separate group of 163 tubal factor couples undergoing IVF after our standard ovulation induction regimen during the period of the study. In summary, the luteal phase hormone profiles of IVF cycles were improved by supplementation with hCG. It is concluded that this type of intervention may serve to rescue potentially failing corpora lutea and thereby optimize the peri-implantation hormonal milieu.
对参与耶鲁大学体外受精（IVF）项目的两组患者的黄体期激素水平进行了比较。对照组（第一组）由28名女性（28个周期）组成，她们接受了我们的标准促排卵方案（无黄体期支持）。治疗组（第二组）由40名女性（42个周期）组成，在首次注射人绒毛膜促性腺激素（hCG）5天后接受10000IU hCG黄体期支持，并进行前瞻性研究。两组在年龄和不孕原因方面相匹配。在胚胎移植当天及之后每3至4天测量雌二醇（E2）和孕酮（P）水平。与第一组相比，黄体期hCG支持显著提高了（1）第二组妊娠周期中的E2和P水平，以及（2）第二组未妊娠周期中的P水平。第一组中观察到的E2和P在黄体中期的下降在第二组中最小化或得到了预防。第二组的持续妊娠率为19%。这与在研究期间接受我们标准促排卵方案后进行IVF的另一组163对输卵管因素夫妇中记录的13%的持续妊娠率相比，在统计学上没有差异。总之，通过补充hCG改善了IVF周期的黄体期激素水平。得出的结论是，这种类型的干预可能有助于挽救潜在功能不全的黄体，从而优化着床期的激素环境。
