Smotrich D B, Widra E A, Gindoff P R, Levy M J, Hall J L, Stillman R J
George Washington University, Division of Reproductive Endocrinology and Fertility, Washington, D.C., USA.
Fertil Steril. 1995 Dec;64(6):1136-40.
To evaluate the prognostic value of day 3 E2 levels, independent of day 3 FSH levels, on responses to ovulation induction and subsequent pregnancy rates (PRs) in IVF-ET patients.
Prospective, observational.
University-based tertiary care and private reproductive endocrine-infertility units.
A total of 225 patients underwent 292 IVF cycles with luteal phase GnRH agonist suppression and hMG stimulation.
We evaluated response and outcome data including age, day 3 FSH and E2 levels from a menstrual cycle before IVF, ampules of hMG used, maximum E2 level, cancellation rates, and clinical PR.
Despite similar age, number of ampules of hMG, and peak E2 levels, patients with an elevated E2 level (E2 > or = 80 pg/mL) (conversion factor to SI unit, 3.671) on day 3 of a cycle before IVF-ET achieved a lower PR per initiated cycle (14.8% versus 37.0%) and had a higher cancellation rate (18.5% versus 0.4%) compared with those with E2 levels < 80 pg/mL. Even when patients with elevated FSH levels (FSH > or = 15 mIU/mL) (conversion factor to SI unit, 1.00) were excluded (leaving 279 cycles), those with an elevated day 3 E2 still had a lower PR per initiated cycle (14.8% versus 38.9%) and maintained a higher cancellation rate (18.5% versus 0.4%). When the day 3 E2 was > or = 100 pg/mL there was a 33.3% cancellation rate and no pregnancies were achieved.
Patients who presented with an elevated day 3 E2 (> or = 80 pg/mL) in a cycle before IVF-ET had a higher cancellation rate and achieved a lower PR independent of FSH level. A day 3 E2 level, in addition to a day 3 FSH level, appears very helpful in prospectively counseling patients regarding cancellation risk and ultimate IVF-ET success.
评估体外受精-胚胎移植（IVF-ET）患者中，第3天雌二醇（E2）水平独立于第3天促卵泡激素（FSH）水平，对排卵诱导反应及后续妊娠率（PR）的预后价值。
前瞻性观察研究。
大学附属三级医疗机构及私立生殖内分泌-不孕症治疗机构。
共225例患者接受了292个IVF周期治疗，采用黄体期促性腺激素释放激素（GnRH）激动剂抑制及人绝经期促性腺激素（hMG）刺激。
我们评估了反应及结局数据，包括IVF前月经周期的年龄、第3天FSH和E2水平、hMG使用安瓿数、最高E2水平、取消率及临床PR。
尽管年龄、hMG安瓿数及E2峰值水平相似，但IVF-ET前一个周期第3天E2水平升高（E2≥80 pg/mL）（换算为国际单位的转换因子为3.671）的患者，每个启动周期的PR较低（14.8%对37.0%），取消率较高（18.5%对0.4%），而E2水平<80 pg/mL的患者则相反。即使排除FSH水平升高（FSH≥15 mIU/mL）（换算为国际单位的转换因子为1.00）的患者（剩余279个周期），第3天E2水平升高的患者每个启动周期的PR仍较低（14.8%对38.9%），取消率仍较高（18.5%对0.4%）。当第3天E2≥100 pg/mL时，取消率为33.3%，且未实现妊娠。
IVF-ET前一个周期第3天E2水平升高（≥80 pg/mL）的患者取消率较高，且独立于FSH水平，PR较低。除第3天FSH水平外。第3天E2水平似乎对前瞻性咨询患者取消风险及最终IVF-ET成功率非常有帮助。
