Lawrenz Barbara, Melado Laura, Fatemi Human
IVI Middle-East, Royal Marina Village, Villa B22-23, Abu Dhabi, UAE; Womeńs university hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany.
IVI Middle-East, Royal Marina Village, Villa B22-23, Abu Dhabi, UAE.
Reprod Biol. 2018 Mar;18(1):1-4. doi: 10.1016/j.repbio.2018.01.001. Epub 2018 Jan 6.
Premature rise of progesterone during the late follicular phase in stimulated IVF cycles is a frequent event and its effect on the endometrial receptivity and on the ART (Assisted Reproductive Technique) - outcome has become a matter of intense debate and research. An emerging body of evidence demonstrates that premature progesterone rise does have a negative impact on the outcome of the ART-success. Until now, the exact cause of progesterone elevation is not fully clear, however lately published studies points to the fact, that premature progesterone elevation might be caused by enhanced FSH stimulation. The impact of elevated peripheral progesterone levels seems to be mainly on the endometrium and the window of implantation, leading to an asynchrony between the endometrium and the developing embryo. Hence, new data show additional an influence on the embryo quality. This review aims to summarize the up-to-date knowledge on the causes of premature progesterone rise during hormonal stimulation, on its influence on endometrial receptivity and embryo quality, on the impact on pregnancy and live birth rates as well as on the possible strategies to prevent this event or to deal with premature progesterone elevation in case it could not be avoided.
在促排卵的体外受精周期中，卵泡晚期孕酮过早升高是常见现象，其对子宫内膜容受性及辅助生殖技术结局的影响已成为激烈争论和研究的焦点。越来越多的证据表明，孕酮过早升高确实会对辅助生殖技术的成功结局产生负面影响。到目前为止，孕酮升高的确切原因尚不完全清楚，但最近发表的研究指出，孕酮过早升高可能是由于促卵泡生成素（FSH）刺激增强所致。外周孕酮水平升高的影响似乎主要作用于子宫内膜和着床窗，导致子宫内膜与发育中的胚胎不同步。因此，新数据显示其对胚胎质量也有额外影响。本综述旨在总结关于激素刺激期间孕酮过早升高的原因、其对子宫内膜容受性和胚胎质量的影响、对妊娠率和活产率的影响，以及预防该事件或在无法避免孕酮过早升高的情况下应对此情况的可能策略的最新知识。
