扳机日血清孕酮水平对IVF/ICSI-ET妊娠结局的影响

Impact of progesterone level on the day of human chorionic gonadotrophin administration on outcome of IVF/ICSI-ET cycles

目的探讨体外受精/卵细胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)周期中,人绒毛膜促性腺激素(HCG)注射日孕激素(P)水平对妊娠结局的影响。方法回顾分析行IVF/ICSI助孕的247个新鲜周期。按照HCG日P水平不同分为5组:A组(P<0.5 ng·m L-1),B组(0.5 ng·m L-1≤P<1 ng·m L-1),C组(1 ng·m L-1≤P<1.5 ng·m L-1),D组(1.5 ng/m L≤P<2 ng·m L-1),E组(P≥2 ng·m L-1)。结果 B组、C组、D组的临床妊娠率(59.78%,60%,56.67%)显著高于A组(43.9%)和E组(21.43%);A组、B组、C组、D组活产率(34.15%,50%,52.86%,50%)显著高于E组(14.29%),差异有统计学意义(P<0.05)。而各组间受精率、卵裂率、优胚率差异均无统计学意义(P>0.05)。结论 HCG日P水平过高或过低均将影响临床妊娠率及活产率但不影响胚胎质量,而P水平过高可能通过影响子宫内膜容受性对妊娠结局更为不利。

Objective To investigate the impact of progesterone levels of human chorionic gonadotropin（h CG） injection days on pregnancy outcome of the in vitro fertilization/intracytoplasmic sperm injection- embryo transfer（IVF/ICSI- ET） cycles.Methods Retrospective analysis of 247 cycles of IVF/ICSI- ET was performed in our reproductive medical centre. All the patients were divided into five groups according to serum progesterone level on the day of h CG administration： group A（P〈0. 5 ng·mL^-1）,group B（0. 5 ng·mL^-1≤ P 1 ng·mL^-1）,group C（1 ng·mL^-1≤ P 1. 5 ng·mL^-1）,group D（1. 5 ng·mL^-1≤ P 2 ng·mL^-1）,and group E（P ≥ 2 ng·mL^-1）. Results The clinical pregnancy rates in groups B,C,D（59. 78%,60% and 56. 67%） were significantly higher than that in groups A（43. 9%） and E（21. 43%）,The live birth rates in groups A,B,C,D（43. 9%,59. 78%,60% and 56. 67%） were significantly higher than that in group E（21. 43%）,the differences were statistically significant（P〈0. 05）.The fertilization rates,embryos rates,high quality embryos rates were had no significant difference in all groups（P〈0. 05）.Conclusion Too high or too low level of progesterone on the day of h CG administration may affect the clinical pregnancy rates and live birth rates,but may be no effect on the quality of embryos. And too high level of P may influence the endometrial receptivity on pregnancy outcome,the outcome may be worse.