Blakemore Jennifer K, Kofinas Jason D, McCulloh David H, Grifo Jamie
Division of Reproductive Endocrinology and Infertility, NYU Langone Medical Center, 660 1st Avenue, New York, NY, 10016, USA.
J Assist Reprod Genet. 2017 Mar;34(3):339-343. doi: 10.1007/s10815-016-0859-1. Epub 2017 Jan 12.
Our objective was to determine if a change in serum P4 from day of transfer (defined as day 19) to day 28 could predict live birth outcome in patients undergoing IVF.
This study was a retrospective analysis of fresh IVF cycles from 2010 to 2013 at a single center. Primary outcomes include raw and percent change in serum P4, live birth rate, missed abortion, and biochemical pregnancies.
Our results showed an association between live birth rate and percent change in P4. Patients with a 10% or greater drop in serum P4 from day 19 to day 28 had a lower live birth rate, at 26 versus 63%. Interestingly, both groups had "normal" serum P4 levels on day 19, but patients with a 10% or greater drop had lower P4 levels than their counterparts. There was no association between percent P4 change and spontaneous abortion or biochemical pregnancy.
This is the first study to show that percent drop in serum P4 from day of transfer to day 28 is associated with decreased rates of live birth and ongoing pregnancy in fresh IVF cycles, even despite "high or normal" P4 levels on day of transfer.
我们的目标是确定从移植日（定义为第19天）到第28天血清孕酮（P4）的变化是否能够预测接受体外受精（IVF）患者的活产结局。
本研究是对2010年至2013年在单一中心进行的新鲜IVF周期的回顾性分析。主要结局包括血清P4的原始变化和变化百分比、活产率、稽留流产和生化妊娠。
我们的结果显示活产率与P4变化百分比之间存在关联。从第19天到第28天血清P4下降10%或更多的患者活产率较低，分别为26%和63%。有趣的是，两组在第19天的血清P4水平均“正常”，但下降10%或更多的患者的P4水平低于对照组。P4变化百分比与自然流产或生化妊娠之间无关联。
这是第一项表明在新鲜IVF周期中，从移植日到第28天血清P4下降百分比与活产率和持续妊娠率降低相关的研究，即使移植日的P4水平“高或正常”。
