体外受精-胚胎移植周期中血清激素水平与着床率关系的研究

The relationship of hormone levels and implantation rate in vitro fertilization and embryo transfer period

目的:探讨体外受精-胚胎移植(IVF-ET)周期中血清激素水平的变化对胚胎着床的影响。方法:回顾分析我中心2000年1月-2003年10月307个采用促性腺激素释放激素激动剂(GnRH-a)降调,并用卵泡雌激素／绝经期促性腺激素／绒毛膜促性腺激素(FSH／HMG／HCG)进行控制性超排卵的IVF-ET周期(297例患者),采用放免测定技术,测定HCG注射日血清雌二醇(E2)、孕酮(P)水平。观察着床情况。所有的平均值以均值士标准差表示。统计学处理采用X2检验。结果:E2>11 000 pmol／L的病例组一级胚胎的发生数与移植数明显增高(P<0.005),而一级胚胎的着床率明显下降(P<0.005),移植胚胎着床率四组之间无显著差异。P<1.6 nmol／L时一级胚胎的移植数与其他组相比明显减少(P<0.005),一级胚胎的着床率四组之间无显著差异,但是移植胚胎着床率P<1.6 nmol／L时却明显降低(P<0.005)。P／E2比值<0.5和>2.0的病例组与0.5<P／E2<2.0病例组相比着床率明显低下(P<0.005)。结论:注射HCG日血E2值与一级胚胎的着床率无相关,E2的临界值没有临床意义。P<1.6 nmol／L胚胎质量下降。P／E2比值过低(<0.5)或过高(>2.0)移植胚胎的质量与着床环境低下,移植着床率下降。

Objective: To study the influence of serum estrodiol (E2) and progesterone (P) level on implantation rate in vitro fertilization and embryo transfer (IVF-ET) . Methods: 285 IVF-ET treatment cycles from January 2000 to September 2003 were studied. E2,P level on the day of HCG administration were measured by radioimmunoassay and the implantation rate was observed. Results: When the serum E2 level is higher than 3000 on the day of HCG administration, the number of good embryo increased greatly (P<0. 005) , When the serum P level is lower than 0. 5 on the day of HCG administration, the number of good embryo decreased greatly (P<0. 005), With P/E2ratio lower than 0. 5 or higher than 2. 0, the embryo implantation rate decreased markedly (F<0. 005) . Conclusion : E2 does not the implantation rate of good embryo. When P is lower than 0. 5, the quality of the embryo will be decreased.