注射HCG日血清雌二醇/孕酮水平与IVF结局的关系

目的探讨在控制性超排卵中注射绒毛膜促性腺激素（HCG）日血清雌二醇/孕酮（E2/P）水平与IVF结局的关系。方法选择已接受试管婴儿治疗且完整资料的741例不孕症患者,据ROC曲线按HCG日E2/P水平亦分为2组：E2/P水平≥1.51组（A1组）与〈1.51组（B1组）。分析2组临床指标和实验室结局的差异。结果不同E2/P组间患者基础卵泡刺激素（FSH）、基础雌二醇（E2）、窦泡数（AFC）、HCG日大于等于14mm卵泡数、获卵数、受精数、2PN数、优胚数、受精率、卵裂率差异均有统计学意义（P〈0.05）。胚胎移植（ET）日内膜厚度、植入率、临床妊娠率的差异均无统计学意义（P〉0.05）。结论在控制性超排卵治疗中,HCG注射日血清孕酮值高者临床妊娠率低,E2/P水平是预测助孕结局（获卵数、卵裂率、优胚数等）的重要指标,注射HCG日E2/P比值降低不利于IVF结局。

Relationship of E_2/P Levels on the Day of HCG Injection and Outcome of in Vitro Fertilization

Objective To investigate the relationship of estradiol/progestogen（E2/P） levels on the day of human chorionic gonadotropin（HCG） injection and the outcome of in vitro fertilization（IVF） in controlled ovarian hyperstimulation.Methods According to a receiver operator characteristic curve,741 patients who had received IVF treatment for infertility were divided into two groups：E2/P levels greater than or equal to 1.51 group（A1 group） and E2/P levels less than 1.51 group（B1 group）.Clinical indicators and laboratory outcome were compared between the two groups.Results There were significant differences in follicle-stimulating hormone（FSH） levels,E2 levels,antral follicle count,the number of follicles greater than 14 mm on the day of HCG injection,the number of oocytes retrieved,the number of fertilized oocytes,the number of 2PN fertilized oocytes,the number of excellent embryos,fertilization rate and cleavage rate between A1 group and B1 group（P0.05）.No differences were observed in endometrial thickness on the day of embryo transfer,implantation rate and clinical pregnancy rate between the two groups（P0.05）.Conclusion E2/P levels are important indicators to predict assisted reproductive outcomes.Infertility patients with high levels of serum P have low pregnancy rates and the decrease in E2/P ratio is not conducive to IVF outcome.