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孕酮水平可预测输卵管性不孕患者的妊娠结局。

Progesterone levels predict pregnancy outcomes in individuals with fallopian tube associated infertility.

机构信息

Shandong University of Traditional Chinese Medicine, No. 4655, University Road, University Science and Technology Park, Changqing District, Shandong, 250355, Jinan, China.

Hospital & Institute of Obstetrics and Gynecology Laboratory for Reproductive Immunology , Shanghai Medical College Fudan University , 200433, Shanghai, China.

出版信息

BMC Pregnancy Childbirth. 2021 Jan 6;21(1):16. doi: 10.1186/s12884-020-03495-6.

Abstract

BACKGROUND

This study aimed at determining the predictive value of human chorionic gonadotropin and progesterone levels on pregnancy outcomes in patients receiving in vitro fertilization due to fallopian tube associated infertility.

METHODS

We retrospectively analyzed the clinical data of 854 cycles due to fallopian tube associated infertility in vitro fertilization fresh embryo transfer. The clinical data had been collected from January 2010 to December 2018 and was divided into 7 groups depending on the progesterone level on human chorionic gonadotropin administration day. Live birth rates and observation trends were calculated. The receiver operating characteristic curve was established to determine the optimal cutoff value for progesterone, which was used to further divide the data into 3 groups; Group 1 (progesterone ≦ 1.0 ng/ml), Group 2 (1.0 ng/ml ≤ progesterone ≤ 1.25 ng/ml), and Group 3 (progesterone ≥ 1.25 ng/ml). We then compared the ovulation results and clinical outcomes among the 3 groups.

RESULTS

There were no significant differences in age, infertility years, gonadotropin dosage, gonadotropin days, Luteinizing hormone level on human chorionic gonadotropin day, 2 pronuclear fertilization rates, clinical pregnancy rates, live birth rates, full-term birth rate, and preterm birth rates among the three groups. However body mass index (p = 0.001), basal luteinizing hormone (p = 0.034), estrogen peak (p < 0.001), number of oocytes obtained (P < 0.001) were significantly different.

CONCLUSIONS

Progesterone level on human chorionic gonadotropin day does not affect the clinical pregnancy rate and live birth rates after in vitro fertilization. However, progesterone levels between 1.0 and 1.25 ng/ml may lead to good clinical pregnancy outcomes.

摘要

背景

本研究旨在确定因输卵管因素不孕行体外受精的患者,人绒毛膜促性腺激素和孕激素水平对妊娠结局的预测价值。

方法

我们回顾性分析了 2010 年 1 月至 2018 年 12 月因输卵管因素不孕行体外受精新鲜胚胎移植的 854 个周期的临床资料。根据人绒毛膜促性腺激素给药日的孕激素水平将临床资料分为 7 组。计算活产率和观察趋势。绘制受试者工作特征曲线确定孕激素的最佳截断值,进一步将数据分为 3 组:第 1 组(孕激素≤1.0ng/ml)、第 2 组(1.0ng/ml<孕激素≤1.25ng/ml)和第 3 组(孕激素≥1.25ng/ml)。然后比较 3 组的排卵结果和临床结局。

结果

3 组间年龄、不孕年限、促性腺激素用量、促性腺激素天数、人绒毛膜促性腺激素日黄体生成素水平、2 原核受精率、临床妊娠率、活产率、足月产率、早产率差异均无统计学意义。但体质量指数(p=0.001)、基础黄体生成素(p=0.034)、雌激素峰值(p<0.001)、获卵数(P<0.001)差异均有统计学意义。

结论

人绒毛膜促性腺激素日孕激素水平不影响体外受精后的临床妊娠率和活产率。但孕激素水平在 1.0~1.25ng/ml 之间可能会带来良好的临床妊娠结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81af/7788974/d12c0b265c17/12884_2020_3495_Fig1_HTML.jpg

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