卵泡黄素化不破裂周期胚胎解冻移植的探讨

The analysis of the outcomes of frozen thawed embryo transfer in luteinized unruptured follicle cycles

目的 研究卵泡黄素化未破裂（luteinized unruptured follicle，LUF）周期对胚胎解冻移植（frozen tha wed embryo transfer，FET）结局的影响。方法 选择本中心2004年1月～2004年12月期间行FET的有卵泡发育的周期．根据预期排卵日卵泡破裂与否分为排卵组（891例）及LUF组（158例），并对2004年11月～2004年12月进行解冻移植的患者分别于移植当日及移植后3d查血清E2和P，比较排卵组及LUF组的血清E2和P。结果 促排卵周期LUF发生率（35．90％）明显高于自然周期（16．16％），差异有显著性（P〈0．05）；经给予不同的黄体支持方案，LUF组移植日及移植后3d血清E2、P水平分别为（507．0±371．9）pmol／L、（62．1±58．2）nmol／L，E2／P为（13．4±12．7）；而正常排卵组则分别为（436．2±298．5）pmol／L，（46．7±39．62）nmol／L及（11．6±11．3），两组相比差异无显著性（P〉0．05）；LUF组临床妊娠率及继续妊娠率分别为27．85％（44／158例）和22．78％（36／158例），而正常排卵组则分别为31．43％（280／／891例）和26．04％（232／891例），差异无显著性（P〉O．05）。结论 LUF周期同样可进行胚胎解冻移植，可获得与正常排卵相似的临床妊娠率，LUF周期解冻移植不影响其结局。

Objective To investigate the outcome of frozen thawed embryo transfer in luteinized unruptured follicle （LUF） cycles. Methods 1 049 patients who had developed follicles in frozen thawed embryo transfer cycle during Jan 2004 to Dec 2004 were studied. They were devided into two groups, the natural ovulation group （891 cases） and the LUF group （158 cases） according if the follicles ruptured or not. The serum E2 and P of those patient were detected on the day accepted transfer follicle and 3ds after transferred. Results There were no significant differences in the patients＇ age, infertility years, months of embryo crypreservation, type of infertility, protocol of fertilization, numbers of transferred embryos, and quality of thawed embryos, injury rates of embryos and thickness of endometrium in these two groups. LUF occurred in 35.90% （14/39 cases） of patients in ovulation induction cycles, showed a significant higher than 16.16% （144/891 cases） in nature cycles （P〈0. 05）. On day FET, the level of E2 and P were （507.0±371.9） pmol/L, （62. 1±58.2） nmol/L, and E2/P ratio was （13.4±12.7） in LUF cycles; while it was （436.2±298. 5） pmol/L, （46.7±39.62） nmol/L and （11.6±11.3） respectively in natural ovulation cycle. On the third day after FET, the E2, P level were （686.9±557. 2） pmol/L, （114. 1±94.9） nmol/L, and E2/P ratio was （8. 2±7.6） in LUF cycles： while it was （586.6±363. 8） pmol/L, （116.1±75.2） nmol/L and （6.5± 4.1）, respectively in natural ovulation cycle . There were no significant differences between these two groups, （ P〉0. 05）. The clinical pregnancy rate and on - going pregnancy rate was 27.85% （44/158 cases） and 22.78% （36/158 cases） in LUF group, and 31.43% （280/891 cases） and 26.04% （232/891 cases） in ovulation group, respectively （P〉0.05）. Conclusions FET procedure could be taken in LUF cycles as same as it in normal ovulation cycles. In LUF cycles there is a preferable clinical pregnancy rate as well as ovulation ones while undergoing FET. Whether LUF or not had no influence on clinical outcomes of FET.