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[血清催乳素对人卵母细胞周期刺激及受精的影响]

[Effect of serum prolactin on cycle stimulation and fertilization of human oocytes].

作者信息

Reinthaller A, Deutinger J, Csaicsich P, Riss P, Müller-Tyl E, Fischl F, Janisch H

出版信息

Geburtshilfe Frauenheilkd. 1987 Apr;47(4):246-8. doi: 10.1055/s-2008-1035816.

Abstract

During cycle stimulation for in-vitro fertilisation (IVF) some patients develop hyperprolactinaemia. Since prolactin (PRL), being an aromatase inhibitor, can interfere with follicular fluid steroid metabolism, we examined the influence of high serum PRL levels on the endocrine response and fertilisation rate of oocytes. 33 consecutive patients stimulated by hMG/hCG for IVF were included in this study. Two groups of patients were established: Group 1 consisting of 18 patients with serum PRL levels less than or equal to 25 ng/ml, and group 2 containing 15 patients, who developed PRL levels greater than 25 ng/ml during cycle stimulation. The serum oestradiol (E2), progesterone (P) and PRL levels 3, 2 and 1 day before and at the day of follicle puncture were evaluated. The decrease of E2 levels at the day of oocyte retrieval was significantly steeper in group 1. The P levels 2 days before oocyte retrieval were significantly higher in group 1 indicating the onset of preovulatory luteinization. Luteinization after the hCG injection was more effective in group 1 resulting in significantly higher P levels. Fertilisation and cleavage rates were significantly higher in patients with normal PRL levels. High serum PRL levels therefore might indicate an interference in follicular and oocyte development leading to oocytes of inferior quality.

摘要

在体外受精(IVF)的周期刺激过程中,一些患者会出现高泌乳素血症。由于泌乳素(PRL)作为一种芳香化酶抑制剂,会干扰卵泡液中的类固醇代谢,因此我们研究了高血清PRL水平对卵母细胞内分泌反应和受精率的影响。本研究纳入了33例连续接受hMG/hCG刺激进行IVF的患者。将患者分为两组:第1组由18例血清PRL水平小于或等于25 ng/ml的患者组成,第2组包含15例在周期刺激过程中PRL水平高于25 ng/ml的患者。评估了卵泡穿刺前3天、2天、1天及穿刺当天的血清雌二醇(E2)、孕酮(P)和PRL水平。卵母细胞采集当天,第1组E2水平的下降明显更陡峭。卵母细胞采集前2天,第1组的P水平显著更高,表明排卵前黄体化开始。hCG注射后的黄体化在第1组中更有效,导致P水平显著更高。PRL水平正常的患者受精率和卵裂率显著更高。因此,高血清PRL水平可能表明对卵泡和卵母细胞发育存在干扰,导致卵母细胞质量较差。

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