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体外受精/卵胞浆内单精子注射周期中HCG触发日血清孕酮水平与卵母细胞成熟及胚胎质量的关系:一项回顾性观察研究。

The relationship between serum progesterone level on the day of HCG trigger in IVF/ICSI cycles and oocyte maturation and embryo quality: a retrospective observational study.

作者信息

Hokmabadi Elham, Salahi Elnaz, Ghasemi Marzieh

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.

出版信息

BMC Womens Health. 2024 Dec 30;24(1):673. doi: 10.1186/s12905-024-03535-9.

Abstract

PURPOSE

Previous studies have suggested a link between serum progesterone levels on the day of the HCG trigger in IVF cycles and oocyte and embryo quality. This study aims to explore this relationship more thoroughly.

METHODS

This study included 496 infertility patients at Moloud Infertility Treatment Center, Zahedan, Iran. Statistical methods were used to assess factors such as oocyte maturation and embryo quality, fertilization rate, BMI, and gonadotropin dosage.

RESULTS

While an initial progesterone cutoff of 1.2 ng/ml was used to perform fundamental analysis, a more accurate cutoff of 1.54 ng/ml was identified, beyond which the average number of M1 oocytes significantly declined. A strong relationship was found between higher progesterone levels and a greater number of retrieved oocytes (p = 0.004), with M1 oocytes showing a similar relation. Also, BMI was significantly related to the quality of eight-cell grade B embryos (p = 0.006). However, no significant correlations were found between progesterone levels and other factors, including patient age (p = 0.327), fertilization rate (p = 0.603), or embryo quality at other stages.

CONCLUSIONS

The findings demonstrate that elevated progesterone level, particularly beyond the identified cutoff of 1.54 ng/ml, is a valuable clinical indicator of suboptimal IVF outcomes due to its negative impact on oocyte maturation.

摘要

目的

以往研究表明,体外受精周期中HCG触发日的血清孕酮水平与卵母细胞和胚胎质量之间存在联系。本研究旨在更全面地探讨这种关系。

方法

本研究纳入了伊朗扎黑丹莫卢德不孕治疗中心的496例不孕患者。采用统计方法评估卵母细胞成熟度、胚胎质量、受精率、BMI和促性腺激素剂量等因素。

结果

在进行基础分析时,最初使用的孕酮临界值为1.2 ng/ml,但确定了更准确的临界值为1.54 ng/ml,超过该值后,M1卵母细胞的平均数量显著下降。发现孕酮水平较高与回收的卵母细胞数量较多之间存在密切关系(p = 0.004),M1卵母细胞也呈现类似关系。此外,BMI与八细胞B级胚胎的质量显著相关(p = 0.006)。然而,未发现孕酮水平与其他因素之间存在显著相关性,包括患者年龄(p = 0.327)、受精率(p = 0.603)或其他阶段的胚胎质量。

结论

研究结果表明,孕酮水平升高,尤其是超过确定的临界值1.54 ng/ml,由于其对卵母细胞成熟的负面影响,是体外受精结果不理想的一个有价值的临床指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d56/11684037/29883f20974c/12905_2024_3535_Fig1_HTML.jpg

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