HCG注射日和胚胎移植日血清雌二醇及孕酮与IVF/ICSI结局的关系

Oestradiol and progesterone concentration on the day of human chorionic gonadotrophin administration and embryo implantation and their relationship with IVF/ICSI outcome

目的探讨hCG注射日血清雌二醇（hCG—E2）和胚胎移植日血清雌二醇（ET—E2）、孕酮（P）及他们之间的比值与IVF／ICSI结局的关系。方法对182个采用促性腺激素激动剂／促卵泡生成素或（和）人绝经期促性腺激素／绒毛膜促性腺激素（GnRH—a／FSH／HMG／hCG）长方案超促排卵的体外受精（IVF）和单精子胞浆内注射（ICSI）的周期，在hCG注射日和胚胎移植日采用化学发光免疫法测定E2和P。结果（1）hCG-E2波动在8000～20000pmol／l时，妊娠率最高（46．8％），与E2〈8000pmol／1和〉20000pmol／1两组相比均有统计学差异（P〈0．05）。（2）移植日E2下降的水平越大，即hCG—E2／ET—E2越大，妊娠率越低。（3）ET日P／E2越高临床妊娠率越低，但排除E2的影响后，比值无意义。结论hCG注射日和ET日E2及其比值对IVF／ICSI的结局可能有预测价值。

Objective： To study plasma oestradiol, progesterone and their ratio on the day of human chorionic gonadotrophin （HCG） and the day of embryo implantation, and the relationship with IVF/ICSI outcome. Methods： 182 women underwent 182 IVF/ ICSI cycles were prospectively analysed. They were employed controll oocytes hyperstimulation （COH） with a long protocol of gonadotrophin - releasing hormane agonist （ GnRH - a） /follicle - stimulating hormone （FSH） or （and） human menopausal gonadotrophin （HCG） /human chorionic gonadotrophin （HCG）. Plasma oestradiol and progesterone on the day of human chorionic gonadotrophin （HCG） and the day of embryo implantation were measured by chemiluminescence immunoassayed. Results ： （ 1 ） When plasma oestradiol level on the day of human chorionic gonadotrophin fluctuated in 8000 - 20000pmol/l, the pregnancy rate was the highest （46. 8% ）. （2） The falling oestradiol on the day of embryo implantation was associated with poor outcome. （3） Regardless of the difference of estradiol , the ratio of progesterone to estradiol on the day of embryos implantion was negative relation with clinical preganancy rate. Conclution ： Plasma oestradiol on the day of embryo implantation and the day of embryo implantation may predict the outcome of IVF/ICSI.