Bu Zhiqin, Zhao Feifei, Wang Keyan, Guo Yihong, Su Yingchun, Zhai Jun, Sun Yingpu
Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, People's Republic of China.
School of Public Health, Zhengzhou University, People's Republic of China.
PLoS One. 2014 Jun 13;9(6):e100011. doi: 10.1371/journal.pone.0100011. eCollection 2014.
In order to explore the relationship between serum progesterone (P) level on the day of human chorionic gonadotrophin (HCG) administration and cumulative live birth rate in patients with different ovarian response during in vitro fertilization (IVF), we carried out this retrospective cohort study including a total of 4,651 patients undergoing their first IVF cycles from January 2011 to December 2012. All patients with a final live birth outcome (4,332 patients) were divided into three groups according to ovarian response: poor ovarian responder (≤5 oocytes, 785 patients), intermediate ovarian responder (6-19 oocytes, 3065 patients) and high ovarian responder (≥20 oocytes, 482 patients). The thresholds for serum P elevation were 1.60 ng/ml, 2.24 ng/ml, and 2.50 ng/ml for poor, intermediate, and high ovarian responders, respectively. Cumulative live birth rate per oocyte retrieval cycle was calculated in each group. The relationship between serum P level and cumulative live birth rate was evaluated by both univariate and multivariate logistic regression analysis. Cumulative live birth rate per oocyte retrieval cycle was inversely associated with serum P level in patients with different ovarian response. For all responders, patients with elevated P level had significantly higher number of oocytes retrieved, but lower high quality embryo rate, and lower cumulative live birth rate compared with patients with normal serum P level. In addition, serum P level adversely affected cumulative live birth rate by both univariate and multivariate logistic regression analysis, independent of ovarian response. Serum P elevation on the day of HCG administration adversely affects cumulative live birth rate per oocyte retrieval cycle in patients with different ovarian response.
为了探讨体外受精（IVF）过程中不同卵巢反应患者在注射人绒毛膜促性腺激素（HCG）当天的血清孕酮（P）水平与累积活产率之间的关系，我们开展了这项回顾性队列研究，共纳入了2011年1月至2012年12月期间首次接受IVF周期治疗的4651例患者。所有有最终活产结局的患者（4332例）根据卵巢反应分为三组：卵巢低反应者（≤5个卵母细胞，785例）、卵巢中反应者（6 - 19个卵母细胞，3065例）和卵巢高反应者（≥20个卵母细胞，482例）。血清P升高的阈值分别为卵巢低反应者1.60 ng/ml、卵巢中反应者2.24 ng/ml和卵巢高反应者2.50 ng/ml。计算每组每个取卵周期的累积活产率。通过单因素和多因素逻辑回归分析评估血清P水平与累积活产率之间的关系。不同卵巢反应患者每个取卵周期的累积活产率与血清P水平呈负相关。对于所有反应者，P水平升高的患者取出的卵母细胞数量显著更多，但优质胚胎率更低，与血清P水平正常的患者相比，累积活产率更低。此外，通过单因素和多因素逻辑回归分析，血清P水平对累积活产率有不利影响，且独立于卵巢反应。HCG注射当天血清P升高对不同卵巢反应患者每个取卵周期的累积活产率有不利影响。
