Lu Xuefeng, Chen Qiuju, Fu Yonglun, Ai Ai, Lyu Qifeng, Kuang Yan Ping
Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200001, China.
Sci Rep. 2016 Aug 8;6:31112. doi: 10.1038/srep31112.
To demonstrate the incidence and effects of elevated progesterone (P) on the trigger day on the outcome of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles using Medroxyprogesterone acetate (MPA) co-treated with Human Menotrophins Gonadotrophin (hMG + MPA), we performed a retrospective analysis including 4106 IVF/ICSI cycles. The cycles were grouped according to the P level on the trigger day: <1 ng/mL, between 1-1.5 ng/ml (including 1), between 1.5-2 ng/mL (including 1.5), and ≥2 ng/mL. The primary outcome measure was live birth rate. The prevalence of P level categories was 12.93% (531/4106), 2.92% (120/4106), and 1.92% (79/4106) in women with P between 1-1.5 ng/mL, between 1.5-2 ng/mL, and ≥2 ng/mL, respectively. The mean stimulation duration, total hMG dose, serum follicle stimulating hormone (FSH), estrogen(E2) on the trigger day and the number of oocytes in patients with elevated P were significantly higher than patients with P < 1 ng/mL (P < 0.05). However, there were no significant differences in the oocyte retrieval rates, fertilization rates, implantation rates, clinical pregnancy rates and live birth rates between the groups based on frozen embryo transfer (FET). We concluded that elevated P on the trigger day had no negative effect on the final outcome of the hMG + MPA treatment cycles based on FET.
为了证明使用醋酸甲羟孕酮(MPA)与人绝经期促性腺激素(hMG + MPA)联合治疗时,扳机日孕酮(P)升高对体外受精(IVF)/卵胞浆内单精子注射(ICSI)周期结局的发生率及影响,我们进行了一项回顾性分析,纳入4106个IVF/ICSI周期。这些周期根据扳机日的P水平分组:<1 ng/mL、1 - 1.5 ng/ml(包括1)、1.5 - 2 ng/mL(包括1.5)以及≥2 ng/mL。主要结局指标是活产率。P水平在1 - 1.5 ng/mL、1.5 - 2 ng/mL以及≥2 ng/mL的女性中,相应P水平分类的患病率分别为12.93%(531/4106)、2.92%(120/4106)和1.92%(79/4106)。P升高患者的平均刺激持续时间、hMG总剂量、扳机日血清卵泡刺激素(FSH)、雌激素(E2)以及卵母细胞数量显著高于P < 1 ng/mL的患者(P < 0.05)。然而,基于冷冻胚胎移植(FET)的各组之间,卵母细胞取卵率、受精率、着床率、临床妊娠率和活产率并无显著差异。我们得出结论,扳机日P升高对基于FET的hMG + MPA治疗周期的最终结局没有负面影响。