Yohkaichiya T, Polson D W, Hughes E G, MacLachlan V, Robertson D M, Healy D L, de Kretser D M
Monash University, Prince Henry's Institute of Medical Research, Monash Medical Centre, Melbourne, Victoria, Australia.
Fertil Steril. 1993 May;59(5):1081-9. doi: 10.1016/s0015-0282(16)55932-9.
To determine the maternal serum concentrations of inhibin, E2, P, and hCG in early pregnancies arising from IVF and ET or GIFT and to assess the value of these hormone measurements in determining outcome of pregnancy.
Serum immunoactive inhibin, E2, P, and hCG levels were measured in the first trimester of pregnancies after IVF-ET and GIFT procedures.
In vitro fertilization and ET or GIFT was undertaken at Monash IVF, Melbourne, Victoria, Australia.
At least two blood samples were collected from 117 women between 4 and 11 weeks of gestation.
The hormone concentrations in the IVF-ET and GIFT pregnancies were compared with those in pregnancies and related to outcome of pregnancy.
Serum inhibin levels in singleton pregnancies were significantly higher than in comparable normal pregnancies. In contrast to normal conceptions in which inhibin concentrations rose to peak at 11 weeks, the levels found in IVF-ET and GIFT singleton pregnancies were high at 5 weeks' gestation and declined subsequently. In twin pregnancies, the inhibin levels were significantly greater than those in singleton pregnancies. In biochemical pregnancies diagnosed by increasing hCG concentrations in the absence of an embryonic sac, inhibin levels were significantly lower than those found in singleton pregnancy, as were E2, P, and hCG levels. In anembryonic pregnancies, diagnosed by the confirmation of an intrauterine gestation sac with no evidence of a fetal complex, inhibin concentrations were highest at week 4 and declined, being significantly lower at all stages of gestation. In ectopic pregnancy, serum inhibin levels were lower at all stages of gestation, whereas E2 concentrations were not lower until 6 weeks and P levels until week 5. Serum hCG levels were significantly lower at all stages of gestation. In women with spontaneous abortions, inhibin levels were lower than singleton pregnancies at 7 weeks.
Serum inhibin concentrations are elevated in pregnancies arising from ovarian hyperstimulation in the first trimester when compared with those in normal pregnancy, probably as a result of the presence of multiple corpora lutea resulting from ovarian hyperstimulation. Serum inhibin, E2, P, and hCG are useful markers of abnormal pregnancy outcome.
测定体外受精 - 胚胎移植（IVF - ET）或配子输卵管内移植（GIFT）后早期妊娠孕妇血清中抑制素、雌二醇（E2）、孕酮（P）和人绒毛膜促性腺激素（hCG）的浓度，并评估这些激素测定在确定妊娠结局中的价值。
在IVF - ET和GIFT术后妊娠的孕早期测定血清免疫活性抑制素、E2、P和hCG水平。
澳大利亚维多利亚州墨尔本莫纳什体外受精中心进行体外受精 - 胚胎移植或配子输卵管内移植。
在妊娠4至11周期间从117名妇女中至少采集两份血样。
将IVF - ET和GIFT妊娠中的激素浓度与正常妊娠中的激素浓度进行比较，并与妊娠结局相关联。
单胎妊娠血清抑制素水平显著高于可比的正常妊娠。与正常妊娠中抑制素浓度在11周时升至峰值不同，IVF - ET和GIFT单胎妊娠在妊娠5周时水平较高，随后下降。双胎妊娠中，抑制素水平显著高于单胎妊娠。在因hCG浓度升高而诊断为生化妊娠但无胚囊的情况下，抑制素水平显著低于单胎妊娠，E2、P和hCG水平也是如此。在经确认有宫内妊娠囊但无胎儿结构证据而诊断为空胚妊娠中，抑制素浓度在第4周时最高，随后下降，在妊娠各阶段均显著较低。在异位妊娠中，血清抑制素水平在妊娠各阶段均较低，而E2浓度直到6周时才降低，P水平直到第5周时才降低。血清hCG水平在妊娠各阶段均显著较低。在自然流产的妇女中，抑制素水平在7周时低于单胎妊娠。
与正常妊娠相比，孕早期因卵巢过度刺激导致的妊娠中血清抑制素浓度升高，可能是由于卵巢过度刺激导致多个黄体存在的结果。血清抑制素、E2、P和hCG是异常妊娠结局的有用标志物。
