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高孕激素对不同卵巢反应患者体外受精-胚胎移植结局的影响。

Effects of high progesterone on outcomes of in vitro fertilization-embryo transfer in patients with different ovarian responses.

机构信息

Reproductive Medical Center, Second Affiliated Hospital of Zhengzhou University , Zhengzhou , China.

出版信息

Syst Biol Reprod Med. 2015 Jun;61(3):161-7. doi: 10.3109/19396368.2015.1033779. Epub 2015 Apr 27.

Abstract

The data of 3,841 cycles undergoing in vitro fertilization-embryo transfer (IVF-ET) in our reproductive Center between January 2003 and December 2013 were retrospectively analyzed. According to the number of oocytes retrieved, this study was divided into the high ovarian response group (oocyte retrieval≥20, 842 cycles), the moderate ovarian response group (5<oocyte retrieval<20, 2008 cycles), and the low ovarian response group (oocyte retrieval≤5, 991 cycles). The treatment outcomes were compared between the patients with an increased progesterone (P) level and the patients where the P level did not increase. With increase in ovarian response, the cut-off values of serum P on the day of human chorionic gonadotrophin (hCG) rose, and respectively were 2.5 ng/ml in the high ovarian response group, 2.25 ng/ml in the moderate ovarian response group, and 1.5 ng/ml in the low ovarian response group. In each group, the clinical pregnancy rate and embryo implantation rate were lower in the patients with an increased P level compared to those where the P level did not increase (all p<0.05). However, there were no significant difference in the fertilization rate, cleavage rate, and high-quality embryo rate (all p>0.05). The increased level of P on the day of hCG may affect the treatment outcomes of IVF-ET. The cut-off values of serum P seem to be associated with ovarian response. Increased ovarian response causes the cut-off values of serum P to rise.

摘要

回顾性分析了 2003 年 1 月至 2013 年 12 月在我院生殖中心进行的 3841 个体外受精-胚胎移植(IVF-ET)周期的数据。根据取卵数将本研究分为高卵巢反应组(取卵数≥20,842 个周期)、中卵巢反应组(5<取卵数<20,2008 个周期)和低卵巢反应组(取卵数≤5,991 个周期)。比较了孕激素(P)水平升高和 P 水平未升高患者的治疗结局。随着卵巢反应的增加,人绒毛膜促性腺激素(hCG)日血清 P 的截断值升高,高卵巢反应组为 2.5ng/ml,中卵巢反应组为 2.25ng/ml,低卵巢反应组为 1.5ng/ml。在每组中,与 P 水平未升高的患者相比,P 水平升高的患者的临床妊娠率和胚胎着床率均较低(均 P<0.05)。但受精率、卵裂率和优质胚胎率差异均无统计学意义(均 P>0.05)。hCG 日 P 水平升高可能会影响 IVF-ET 的治疗结局。血清 P 的截断值似乎与卵巢反应有关。卵巢反应增加导致血清 P 的截断值升高。

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