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人辅助生殖治疗中,注射人绒毛膜促性腺激素当天高孕酮水平的影响。

The impact of high progesterone levels on the day of HCG administration in assisted human reproduction treatments.

作者信息

Tanada Michelli S, Yoshida Ivan H, Santos Monise, Berton Caroline Z, Souto Elen, Carvalho Waldemar P de, Cordts Emerson B, Barbosa Caio P

机构信息

Instituto Ideia Fértil de Saúde Reprodutiva, Santo André - SP, Brazil.

Faculdade de Medicina do ABC, Santo André - SP, Brazil.

出版信息

JBRA Assist Reprod. 2018 Jun 1;22(2):99-101. doi: 10.5935/1518-0557.20180020.

Abstract

OBJECTIVE

Progesterone is a steroid hormone that acts on the endometrium. It is known for producing physical and mood-related side effects. Few studies have looked into how progesterone levels affect embryo development and quality. This study aimed to find a cutoff level for serum progesterone on the day of HCG administration from which embryo quality is impaired.

METHODS

The study included 145 cycles, from which 885 oocytes and 613 embryos were obtained. All patients had their serum progesterone levels measured on the day of HCG administration. Data sets were collected from patient medical records. The chi-square test was used to assess qualitative variables and the Mann-Whitney test to evaluate quantitative variables.

RESULTS

Statistical analysis revealed that serum progesterone levels and reproductive variables were not significantly associated. In regards to oocyte maturity, however, when progesterone levels were greater than 1.3 ng/mL the probability of oocytes being immature increased by 12.7%. The fragmentation rate of embryos categorized as "top quality" in D3 increased proportionately to increases in progesterone levels (12.23%).

CONCLUSION

High progesterone levels appeared to be correlated with increased embryo fragmentation rates, but high serum levels of the hormone on the day of HCG administration had no impact on reproductive variables and were not associated with impaired embryo development.

摘要

目的

孕酮是一种作用于子宫内膜的甾体激素。它因会产生身体和情绪方面的副作用而为人所知。很少有研究探讨孕酮水平如何影响胚胎发育和质量。本研究旨在找出人绒毛膜促性腺激素(HCG)给药当天血清孕酮的一个临界水平,超过该水平胚胎质量会受到损害。

方法

该研究纳入了145个周期,从中获得了885个卵母细胞和613个胚胎。所有患者在HCG给药当天均检测了血清孕酮水平。数据集从患者病历中收集。采用卡方检验评估定性变量,采用曼-惠特尼检验评估定量变量。

结果

统计分析显示血清孕酮水平与生殖变量无显著相关性。然而,就卵母细胞成熟度而言,当孕酮水平大于1.3 ng/mL时,卵母细胞不成熟的概率增加了12.7%。第三天被归类为“优质”的胚胎碎片率随孕酮水平的升高而成比例增加(12.23%)。

结论

高孕酮水平似乎与胚胎碎片率增加相关,但HCG给药当天血清激素水平升高对生殖变量无影响,且与胚胎发育受损无关。

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本文引用的文献

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Recurrent IVF failure is associated with elevated progesterone on the day of hCG administration.反复体外受精失败与 hCG 给药日孕酮升高有关。
Eur J Obstet Gynecol Reprod Biol. 2013 Nov;171(1):78-83. doi: 10.1016/j.ejogrb.2013.08.025. Epub 2013 Aug 17.

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