Shulman A, Ghetler Y, Beyth Y, Ben-Nun I
Department of Obstetrics and Gynecology, Sapir Medical Center, Kfar Saba, Israel.
J Assist Reprod Genet. 1996 Mar;13(3):207-11. doi: 10.1007/BF02065937.
Our purpose was to assess and clarify the mechanism of whether an early progesterone rise in cycles with gonadotropin-releasing hormone agonist (GnRH-a) is associated with an impairment of IVF outcome.
Seven hundred eighty-six cycles were induced with GnRH-a and human menopausal gonodotropin (hMG) ("long protocol"). Plasma progesterone (PP) levels on the day of human chorionic gonadotropin (hCG) administration were divided into three groups: < 0.9 ng/ml (Group A), 1-2 ng/ml (Group B), and > 2 ng/ml (Group C). We also analyzed the pregnancies achieved in our egg donation protocol in relation to the PP levels of each donor on the day of hCG administration.
Group A involved 525 cycles, Group B had 223, and Group C had 38. The overall pregnancy rate per egg transfer was 19.2%, with the highest for Group A (22.3%), declining for Groups B (14.3%) and C (7.9%) (A = B = C; P < 0.005). The embryo implantation rate was found to be negatively correlated with the PP levels on the day of hCG administration. In contrast, there was an opposite trend between PP levels and the chance of conception in 30 pregnancies achieved by egg donation.
Since premature luteinization is very unlikely to occur under the conditions of this study, our findings suggest that an early PP rise has a negative impact on endometrial receptivity but not on egg and embryo quality.
我们的目的是评估并阐明在使用促性腺激素释放激素激动剂（GnRH-a）的周期中，孕酮早期升高是否与体外受精（IVF）结局受损相关的机制。
采用GnRH-a和人绝经期促性腺激素（hMG）诱导786个周期（“长方案”）。在注射人绒毛膜促性腺激素（hCG）当天的血浆孕酮（PP）水平分为三组：<0.9 ng/ml（A组）、1 - 2 ng/ml（B组）和>2 ng/ml（C组）。我们还分析了在我们的卵子捐赠方案中，与每个供体在hCG注射当天的PP水平相关的妊娠情况。
A组有525个周期，B组有223个，C组有38个。每次胚胎移植的总体妊娠率为19.2%，A组最高（22.3%），B组（14.3%）和C组（7.9%）下降（A与B、C相比；P<0.005）。发现胚胎着床率与hCG注射当天的PP水平呈负相关。相比之下，在通过卵子捐赠实现的30次妊娠中，PP水平与受孕几率之间存在相反的趋势。
由于在本研究条件下不太可能发生过早黄素化，我们的研究结果表明，PP早期升高对子宫内膜容受性有负面影响，但对卵子和胚胎质量没有影响。
