Molo M W, Rawlins R G, Binor Z, Kelly M, Radwanska E
Department of Obstetrics and Gynecology, Rush Medical College, Chicago, Illinois 60612, USA.
J Reprod Med. 1995 Jun;40(6):418-22.
To correlate luteal estradiol (E2) levels with pregnancy outcome, 36 consecutive conceptions resulting from gamete intrafallopian transfer in gonadotropin releasing hormone agonist/human menopausal gonadotropin (GnRH-a/hMG) cycles were analyzed. GnRH-a was initiated during the preceding luteal phase. HMG was adjusted individually. Human chorionic gonadotropin (hCG), 5,000 IU, was administered when E2 was > 500 pg/mL and the leading follicle > 17 mm (day 0). The luteal phase was supported by (1) hCG, 1,500 IU in three doses from day 5 and (2) progesterone (P) from day 7. E2 and P levels were analyzed in three groups of patients: normally progressing pregnancy (NPP), abortion (AB) and preclinical abortion (PAB). No significant differences in mean E2 levels were seen between the groups from day 0 through day 5 after hCG. Midluteal E2 levels were significantly different between the groups (P < .05). Late luteal E2 values were significantly higher for NPP than for either AB or PAB (P < .05). There were no significant differences in luteal P values between the NPP, AB and PAB groups. Decreased luteal E2 appears to be associated with early pregnancy wastage; this may be due to inadequate endometrial support.
为了将黄体期雌二醇（E2）水平与妊娠结局相关联，对36例在促性腺激素释放激素激动剂/人绝经期促性腺激素（GnRH-a/hMG）周期中通过配子输卵管内移植产生的连续妊娠进行了分析。GnRH-a在前一个黄体期开始使用。HMG进行个体化调整。当E2>500 pg/mL且主导卵泡>17 mm时（第0天），给予5000 IU人绒毛膜促性腺激素（hCG）。黄体期通过以下方式支持：（1）从第5天开始分三次给予1500 IU hCG，以及（2）从第7天开始给予孕酮（P）。对三组患者的E2和P水平进行了分析：正常进展妊娠（NPP）、流产（AB）和临床前流产（PAB）。在hCG后第0天至第5天，各组之间的平均E2水平未见显著差异。黄体中期各组之间的E2水平有显著差异（P<.05）。NPP组的黄体晚期E2值显著高于AB组和PAB组（P<.05）。NPP、AB和PAB组之间的黄体期P值无显著差异。黄体期E2降低似乎与早期妊娠丢失有关；这可能是由于子宫内膜支持不足所致。
