Laufer N, DeCherney A H, Tarlatzis B C, Naftolin F
Fertil Steril. 1986 Jul;46(1):73-6. doi: 10.1016/s0015-0282(16)49460-4.
One hundred forty-four women suffering from obstructive tubal disease underwent laparoscopy for in vitro fertilization and embryo transfer (IVF-ET). Ovulation was induced by a human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG) protocol. The patients were divided according to their estradiol (E2) response to hMG/hCG administration: group A, an increase of E2 levels on the day after hCG administration (day +1); group B, a decrease of E2 levels on the day after hCG administration. Each of these groups was further subdivided into high responders (E2 greater than 500 pg/ml on day 0), designated A-1 and B-1, respectively, and low responders (E2 less than 500 pg/ml on day 0), designated A-2 and B-2, respectively. Patients responding in an A-1 pattern had significantly higher E2 levels from day 0 to day +8. Fertilization and cleavage rates did not differ among the groups, nor did luteal-phase progesterone. Twenty-one pregnancies were achieved from 126 transfers (17%), of which 16 (75%) occurred in women responding in an A pattern. We recommend that laparoscopy be deferred in women responding with a B pattern, because this preselection may increase pregnancy rates per IVF-ET cycle.
144名患有输卵管阻塞性疾病的女性接受了腹腔镜检查以进行体外受精和胚胎移植（IVF-ET）。通过人绝经期促性腺激素/人绒毛膜促性腺激素（hMG/hCG）方案诱导排卵。根据患者对hMG/hCG给药后的雌二醇（E2）反应将患者分组：A组，hCG给药后第1天（+1天）E2水平升高；B组，hCG给药后第1天E2水平降低。每组再进一步细分为高反应者（第0天E2大于500 pg/ml），分别指定为A-1和B-1，以及低反应者（第0天E2小于500 pg/ml），分别指定为A-2和B-2。以A-1模式反应的患者从第0天到第+8天的E2水平显著更高。各组之间的受精率和卵裂率以及黄体期孕酮水平均无差异。126次移植中有21例妊娠成功（17%），其中16例（75%）发生在以A模式反应的女性中。我们建议对于以B模式反应的女性推迟腹腔镜检查，因为这种预先选择可能会提高每个IVF-ET周期的妊娠率。
