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[促黄体生成素释放激素激动剂和人绝经期促性腺激素用于体外受精卵巢刺激时血浆孕酮(快速检测法)的价值]

[Value of plasma progesterone (rapid assay) during ovarian stimulation for in vitro fertilization using LHRH agonists and hMG].

作者信息

Boulieu D, Ayzac L, Nanez M, Karass M, Payan F, Guérin J F, Mathieu C, Pinatel M C

机构信息

Département de gynécologie, oncologie, gynécologique, sénologie, médecine de la reproduction, Hôpital Edouard-Herriot, Lyon.

出版信息

Contracept Fertil Sex. 1993 Jan;21(1):27-32.

PMID:7951590
Abstract

We have studied all the cycles (= 276) induced for in vitro fertilization using a LHRH agonist and the hMG (113 short protocols, 163 long protocols) from 01.90 to 07.90 to know the plasmatic profiles of the estradiol (E2), of the LH and specially of the progesterone (P) between J-7 and the day of the hCG (= J0). We observe in the short protocol an elevation (effect flare up) and afterwards a fall concomitant of the P and of the LH up to J-5, J-6 (effect of pituitary down regulation), in the short and long protocols a progressive elevation of J-3 up to J0 of the P parallel to E2, so that the LH remain stable or decrease. The LH of J0 is higher in short protocol than in long protocol (10.14 +/- 2.9 versus 4.72 +/- 1.3 Ul/l, p < 0.00001). We found the same progressive elevation of the P of J-3 up to J0 in pregnant and not pregnant patients. The surveillance of the P coupled to the E2 and to the follicular ultrasonography could help in the choice of the day of the hCG and avoid a post-maturity of oocyte. The consequences of the elevation of P In the morning of J0 have been study for P levels < 1 ng/ml (73 cases) and P > or = 1 ng/ml (203 cases) and afterwards for progressive elevation of P levels (1.5-2-2.5-3 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们研究了1990年1月至1990年7月期间使用促黄体生成素释放激素(LHRH)激动剂和人绝经期促性腺激素(hMG)进行体外受精诱导的所有周期(共276个周期,其中113个短方案,163个长方案),以了解在hCG注射日(=J0)前7天(J-7)至当天雌二醇(E2)、促黄体生成素(LH)特别是孕酮(P)的血浆水平变化情况。我们观察到,在短方案中,孕酮和促黄体生成素在J-5、J-6时出现升高(flare-up效应),随后下降(垂体下调效应);在短方案和长方案中,从J-3至J0,孕酮与E2平行逐渐升高,促黄体生成素则保持稳定或下降。短方案中J0日的促黄体生成素水平高于长方案(分别为10.14±2.9与4.72±1.3 Ul/l,p<0.00001)。我们发现,怀孕和未怀孕患者从J-3至J0孕酮均有相同的逐渐升高情况。结合E2和卵泡超声监测孕酮水平有助于选择hCG注射日,避免卵母细胞过熟。我们还研究了J0日上午孕酮水平<1 ng/ml(73例)和孕酮≥1 ng/ml(203例)时孕酮升高的后果,以及随后孕酮水平逐渐升高(1.5 - 2 - 2.5 - 3 ng/ml)的情况。(摘要截取自250字)

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