a Médecine de la Reproduction , CHU Toulouse , Toulouse , France.
b Groupe de Recherche en Fertilité Humaine , Université Paul Sabatier , Toulouse , France.
Gynecol Endocrinol. 2019 Jun;35(6):481-484. doi: 10.1080/09513590.2018.1538346. Epub 2019 Jan 2.
The study aimed to assess the impacts and the targets of progesterone (P4) and estradiol (E2) levels on IVF outcomes in GnRH antagonist protocols. The study was retrospective and concerned patients for their first fresh embryo transfers, after stimulation by a recombinant FSH (rFSH)-GnRH antagonist protocol, between September 2012 and July 2017 in the Toulouse University Hospital. Multivariable analysis, taking into account female age and the ovarian stimulation index, showed that E2 levels had no impact on IVF outcomes, while high P4 levels (>1.10 ng/mL) were associated to low pregnancy rate. The P4 concentrations were significantly negatively correlated to the percentage of top embryos and to the implantation rate. Therefore, the deleterious effect of high levels P4 could to act mainly by impairing embryo quality, which questions the place of the freeze-all strategy in these cases.
本研究旨在评估 GnRH 拮抗剂方案中孕激素（P4）和雌二醇（E2）水平对 IVF 结局的影响和作用靶点。该研究为回顾性研究，纳入 2012 年 9 月至 2017 年 7 月在图卢兹大学医院接受重组 FSH（rFSH）-GnRH 拮抗剂方案促排卵后行首次新鲜胚胎移植的患者。多变量分析考虑了女性年龄和卵巢刺激指数，结果表明 E2 水平对 IVF 结局无影响，而高 P4 水平（>1.10ng/mL）与低妊娠率相关。P4 浓度与优质胚胎百分比和种植率显著负相关。因此，高水平 P4 的有害作用可能主要通过损害胚胎质量起作用，这使得在这些情况下采用全胚冷冻策略受到质疑。
