血清性激素含量与体外受精-胚胎移植结局的关系分析

The study on the relationship between serum sex hormone and outcome in IVF-ET

目的 探讨在控制性超排卵中血清性激素变化与妊娠结局的关系。方法 随机选择兰州大学第一医院辅助生殖医学中心2003—2004已接受试管婴儿技术治疗，采用黄体期长方案进行控制性超排卵临床妊娠病例147例，未妊娠140例，分析比较组间各项观察指标。结果 两组间患者降调节时间、促性腺激素（Gn）总量、募集卵泡数、获卵数、MII卵数差异均有显著性（P〈0．05），HCG注射日血清孕酮（P）值、血清雌二醇／孕酮（E2／P）比值差异有显著性（P〈0．05）；促性腺激素释放激素激动剂（GnRH—a，达菲林）用量、Gn天数差异无显著性（P〉0．05），降调节后血清黄体生成素（LH）、HCG注射日血清E2、取卵日血清E2、胚胎移植日血清催乳激素（PRL）水平差异无显著性（P〉0、05）。结论 在控制性超排卵治疗中，观察调控血清性激素含量至关重要。HCG注射日血清P值、E2／P比值是预测助孕结局的重要指标，血清E2／P值在1．32—6．11，血清P值在0．637—1.645μg/L时，临床妊娠率增加。

Objective To evaluate the effects of serum sex hormone on the outcome of ART in controlled ovarian hyperstimulation. Methods During long term protocol of IVF-ET cycles, 287 infertility patients who underwent the controlled ovarian hyperstimulation between 2003 and 2004 were analyzed retrospectively. They were divided into the successful group （ 147 cases） and the unsuccessful group （ 140 cases） according to the clinical outcome. The clinical and laboratory. variables and serum sex hormone were tested. Results Between two groups, there are significant differences in the period of down regulation, the total dosage of gonadotropin, the numbers of recruitment follicle, oocyte retrieval and MII oocyte, serum P and E2/P ratio on the day of HCG administration （P 〈 0.05 ） ; GnRH-a（Triptorelin） dose, the period of ovarian hyperstimulation, serum LH during down regulation, serum E2 on the day of HCG administration and oocyte retrieval and serum PRL in embryo transfer day had no significant differences （ P 〉 0. 05 ）. Conclusion In controlled ovarian hyperstimulation, it is essential to regulate variance of serum sex hormone. In proper proportion, serum E2/P and P on the day of HCG administration can predict outcome.