降调后血清雌激素水平预测IVF结局的价值

Evaluation of the predictive value for IVF outcomes of serum estrogen level after down regulation

目的探讨在IVF助孕过程中,对垂体进行降调节后,基础血清雌激素的水平对预测IVF妊娠结局的意义。方法回顾分析202例临床周期,均采用黄体中期长方案对垂体进行降调节,按降调后启动日基础血清雌激素水平分为3组,分别为E2<15pg/ml,15pg/ml<E2≤30pg/ml,30pg/ml<E2≤50pg/ml,探讨启动日基础血清雌激素水平对助孕结局的预测价值。结果 15pg/ml<E2≤30pg/ml组用药量及Gn天数最少,获卵数最多,另两组患者的用药量较多,获卵数相对较少,3组患者在Gn用量、获卵数,妊娠率及周期取消率方面均没有显著性差异。结论启动日患者15pg/ml<E2≤30pg/ml将会有低的用药量和较多的获卵数,单独以启动日E2这个指标,预测卵巢不良反应的发生及妊娠结局,尚不能说明问题,应结合更多因素进行分析预测。

Objective To investigate the predictive relevance for pregnancy outcomes of basal serum estrogen levels after pituitary down regulation during in-vitro fertilization（IVF） procedures.Methods To review total 202 IVF-ET cycles,which were down regulated by long protocol at mid-luteal phase,were retrospectively analyzed and were divided into 3 groups according to the basal serum estrogen levels on first day of ovarian hyper-stimulation,i.e.E215pg/ml group,15pg/mlE2≤30pg/ml group,and 30pg/mlE2≤50pg/ml group.The predictive value of basal serum estrogen levels on first day of ovarian hyper-stimulation for IVF outcomes was analyzed.Results Gonadotropin consumption and days of ovarian stimulation were the least and numbers of oocyte obtained were the most in 15pg/mlE2≤30pg/ml group,the drug consumption in the other 2 groups were relatively more and numbers of oocyte obtained were relatively less.There were no significant differences in gonadotropin doses,numbers of oocyte obtained,pregnancy rate and cycle cancellation rate between all three groups.Conclusion Patients in the group with 15pg/mlE2≤30pg / ml on the first day of ovarian hyper-stimulation were associated with less gonadotropin consumption and more oocytes obtained,but the single measurement of E2 on the first day of ovarian hyper-stimulation is not sufficient for prediction of adverse reactions and pregnancy outcomes,more factors should be considered for this prediction.