排卵期单个成熟卵泡血清雌二醇水平与周期妊娠率的关系

The Relationship between the Level of Serum Estradiol of Single Mature Follicle and the Pregnancy Rate

目的观测卵泡大小、子宫内膜厚度、血清E_2水平、尿LH峰及宫颈粘液评分,探讨排卵期单个成熟卵泡血清雌二醇(E_2)水平与周期妊娠率的关系。方法对198例在我院生殖科行供精人工授精,至少一侧输卵管通畅的不孕患者的卵泡大小、子宫内膜厚度、排卵前3日内的血清E_2水平,半定量尿LH峰和宫颈粘液进行监测或评分。按排卵期单个成熟卵泡血清E_2值分成A、B、C三组,A组E_2<110pg/ml,B组110~300pg/ml,C组>300pg/ml,观察三组的周期妊娠率。结果 (1)三组的年龄、不孕年限、采血时间、排卵前成熟卵泡平均值及子宫内膜厚度均无显著差异(P>0.05);(2)三组的宫颈粘液评分A组明显低于B、C两组(P<0.01),B、C两组间无显著差异(P>0.05);三组的排卵日尿LH峰水平为A<B<C,有显著性差异;(3)三组周期妊娠率分别为5%(1/20)、38.37%(33/86),41.38%(24/58),A组明显低于B、C两组(P<0.01),B、C两组间无显著差异(P>0.05)。结论排卵期单个成熟卵泡血清E_2水平与宫颈黏液评分、尿LH峰成正比,与卵泡大小、子宫内膜厚度无显著相关;若低于110pg/ml,周期妊娠率显著降低。单个成熟卵泡血清E_2水平更能反映卵子和子宫内环境质量,能更好的预测周期妊娠结局。

Objective To explore the relationship between the level of serum estradiol （E2） of single mature follicle during ovulation and the rate of pregnancy, by observing the follicular size, en- dometrial thickness, serum E2 level, urine hormone（LH） peak and the cervical mucus score. Methods 104 cases of infertility patients with follicular size,endometrial thickness, serum E2 levels within the first 3 days of ovulation, semi quantitative LH peak and neck mucus and other indicators were monitored or scored, these patients are in the reproductive department of our hospital for artificial insemination and at least one side of the fallopian tube is unobstructed. The patients were divided into three groups of A, B and C according to the E2 value of the single mature follicle in the ovulation period （A group 〈110pg/ml, B group 110-300 pg/ml, C group〉300 pg/ml）. and then the rate of pregnancy in the three groups was observed. Results （1）There was no significant difference between the three groups in the age, duration of infertility, the time of blood collection, the average size of the mature follicle and the thickness of endometrium （P〉0.05）.（2） The cervical mucus score of A group was significantly lower than that of B group and C group （P〈O.O1）, and there was no significant difference between B and C group （P〉0.05）;the LH peak level of three days of ovulation was A〈B〈C, and there was significant difference.（3）The pregnancy rate of the three groups were 5%（1/20）, 38.37%（33/86）, and 41.38%（24/58）, respectively. A group was significantly lower than B, C two group （P〈0.01）,and there was no significant difference be- tween the B and C groups （P〉0.05）. Conclusion The serum E2 level of a single mature follicle was directly proportional to the cervical mucus score and urinary LH peak, but was not signifi- cantly correlated with follicular size and endometrial thickness; and if it was lower than110pg/ml, the cycle pregnancy rate was significantly lower. The serum E2 level of a single mature follicle can better reflect the quality of the egg and the womb environment, and can better predict the pregnancy outcome.