HCG日血清激素水平对供精体外受精妊娠结局的影响

Impact of serum hormones levels on the day of human chorionic gonadotropin injection on outcome of in vitro fertilization and embryo transfer with donor semen

目的:探讨在控制性超排卵(COH)过程中人绒毛膜促性腺激素(human chorionic gonadotropin HCG)注射日激素水平与供精体外受精-胚胎移植(in vitro fertilization and embryo transfer with donor seman,IVF-D/ICSI-D)结局的关系。方法:回顾性分析2007年12月～2011年10月在郑州大学第三附属医院生殖医学中心行IVF-D或ICSI-D助孕的157例患者170个取卵周期资料,比较妊娠组及非妊娠组HCG日激素水平与妊娠结局的相关性,并根据HCG日孕酮水平分为≤0.9μg/L组及>0.9μg/L组,比较两组间的各项指标变化。结果:妊娠组HCG日孕酮水平明显低于未妊娠组(P<0.05);孕酮>0.9μg/L组较≤0.9μg/L组HCG日血清E2水平、获卵率升高(P<0.05),而可利用胚胎率、优质胚胎率降低(P<0.05),胚胎种植率和临床妊娠率明显降低(P<0.05);两组受精率、卵裂率及冻融胚胎移植周期临床妊娠率差异无统计学意义(P>0.05)。结论:HCG日孕酮水平一定程度上影响卵子质量及子宫内膜容受性,根据HCG日孕酮值可有效预测供精体外受精胚胎移植的妊娠结局。

Objective:To explore the relationship between serum hormones levels on the day of human chorionic gonadotropin(HCG) injection and outcome of in vitro fertilization and embryo transfer with donor semen(IVF-D/ICSI-D) during controlled ovarian hyperstimulation(COH).Methods:The data of 170 cycles of 157 patients receiving IVF-D or ICSI-D in the hospital from December 2007 to October 2011 were analyzed retrospectively.The hormones levels on the day of HCG injection were compared between pregnancy group and non-pregnancy group,the correlation between hormones levels on the day of HCG injection and pregnancy outcome was analyzed;the patients were divided into progesterone≤0.9 μg/L group and progesterone>0.9 μg/L group according to progesterone level on the day of HCG injection;the changes of different indexes were compared between the two groups.Results:The level of progesterone on the day of HCG injection in pregnancy group was statistically significantly lower than that in non-pregnancy group(P<0.05).The level of serum estradiol and the rate of retrieved oocytes in progesterone>0.9 μg/L group were statistically significantly higher than those in progesterone≤0.9 μg/L group(P<0.05),while the rate of available embryos,high quality embryos,implantation rate,and clinical pregnancy rate in progesterone>0.9 μg/L group were statistically significantly lower than those in progesterone≤0.9 μg/L group(P<0.05).There was no statistically significant difference in fertilization rate,cleavage rate,and clinical pregnancy rate of frozen thawed embryo transfer cycles between the two groups(P>0.05).Conclusion:The level of progesterone on the day of HCG injection has impact on the quality of oocytes and endometrial receptivity to a certain degree,the pregnancy outcome of IVF-D/ICSI-D can be effectively predicted according to progesterone level on the day of HCG injection.