不同黄体支持方法对体外受精-胚胎移植结果的影响

Effect of Different Luteal Support Treatment on In Vitro Fertilization-embryo Transfer

目的:探讨三种黄体支持方法对体外受精-胚胎移植(IVF-ET)结果的影响。方法:回顾性分析195个IVF-ET周期的结果,根据注射hCG当天的血E2水平、B超示直径≥14 mm卵泡数目及所用的黄体支持方法分组。A组:112例,E2<2 000 pg/mL,直径≥14 mm的卵泡数<10个,hCG进行黄体支持;对E2≥2 000 pg/mL,卵泡数目≥10个者,随机分为两组,B组,46例,单用黄体酮进行黄体支持;C组,37例,黄体酮加雌激素进行黄体支持。结果: 三组间妊娠率、种植率、流产率、OHSS发生率差异均无显著性,P>0.05。结论:hCG用于IVF黄体支持并不优于黄体酮,但在一定程度上可避免某些患者由于注射黄体酮产生的痛苦。黄体酮+雌激素进行黄体支持应该是黄体支持较合理的方案,还需进一步研究。

Objective: To study the effect of different luteal support treatments on in vitro fertilization-embryo transfer. Methods: In this study 195 IVF-ET cycles were evaluated retrospectively. They were divided into3 groups according to serum estrogen (E2) level and the number of follicular with diameter≥ 14 mm by B ultra-sonic examination on the day of human chrionic gonadotropin (hCG) injection and luteal support treatment. GroupA :112 cycles, serum E2<2 000 pg/mL, follicular number<10, with hCG as luteal support; if serum E2 ≥2 000pg/mL, follicular number≥10, they were divided into group B and group C randomly . Group B:46 cycles, withprogesterone as luteal support;Group C:37 cycles, with progesterone and estrogen as luteal support.Results: There are no statistical differences between the 3 groups in implantation rates, clinical pregnancy rates,ovary hyperstimulation syndrome rates and spontaneous abortion rates. Conclusion: hCG is not better than proges-terone as luteal support of IVF, but it may avoid some patients from the injection of progesterone. It is suggestedthat the treatment of progesterone combined estrogen is a reasonable for luteal support and should be studiedfurther.