体外受精-胚胎移植术后7天血清雌、孕激素水平与临床结局的相关性研究

Correlation between serum estradiol or progesterone Level on day 7 after IVF-ET and clinical outcome in women with infertility

目的分析体外受精-胚胎移植术后7天血清雌、孕激素水平与临床结局的相关性。方法选择2015年7月-2015年12月我院行IVF-ET的患者新鲜胚胎移植354周期,均于胚胎移植术后7天采血,检测血清雌二醇和孕酮的水平,统计分析血清性激素与临床结局的相关性。结果鲜胚移植周期妊娠组与未妊娠组相比,雌二醇及孕酮水平均显著升高(P<0.05),鲜胚移植周期雌二醇水平以150pg/ml分组,小于150pg/ml组与大于等于150pg/ml组相比,临床妊娠率显著降低(38.82%vs 72.28%,P<0.05),种植率显著降低(23.74%vs 51.50%,P<0.05),早期流产率显著升高(24.24%vs7.52%,P<0.05),活产率显著降低(24.12%vs 58.15%,P<0.05)。鲜胚移植周期孕酮水平以15ng/ml分组,小于15ng/ml组与大于等于15ng/ml组相比,临床妊娠率显著降低(49.10%vs 62.57%,P<0.05),种植率显著降低(30.30%vs 45.16%,P<0.05),早期流产率显著升高(15.85%vs11.11%,P<0.05),活产率显著降低(32.93%vs 49.73%,P<0.05)。结论 IVF-ET术后7天血清雌、孕激素水平可预测临床结局,雌、孕激素低的患者增加外源性雌、孕激素药物并不能改善结局。

Objective：To analyze the relationship between serum estradiol or progesterone level on day 7 after in vitro fertilization and embryo transfer（IVF-ET）and clinical outcome in women with infertility. Methods：354 cases undergoing fresh embryo transplantation of IVF-ET in our hospital from Jul. 2015 to Dec. 2015 were retrospectively enrolled,and their serum estradiol or progesterone level on day 7 after IVF-ET was detected. The correlation between the level of serum estradiol or progesterone and clinical outcome was statistically analyzed. Results：When compared with non pregnant group,the level of estradiol and progesterone were all significantly increased in pregnant group（all P〈0.05）. When compared with the group with higher estradiol level（≥150 pg/ml）,the clinical pregnancy rate deceased significantly（38.82% vs72.28%,P〈0.05）,implantation rate decreased significantly（23.74% vs 51.50%,P〈0.05）,early abortion rate increased significantly（24.24% vs 7.52%,P〈0.05）,and the live birth rate reduced significantly（24.12% vs 58.15%,P〈0.05）in the group with lower estradiol level（150 pg/ml）.When compared with the group with higher progesterone level（≥15 pg/ml）,the clinical pregnancy rate decreased significantly（49.10% vs 62.57%,P〈0.05）,implantation rate decreased significantly（30.30% vs 45.16%,P〈0.05）,early abortion rate increased significantly（15.85% vs 11.11%,P〈0.05）,and the live birth rates reduced significantly（32.93% vs 49.73%,P〈0.05）in the group with lower progesterone level（15 pg/ml）. Conclusion：The serum estrogen and progesterone levels on day 7 after IVF-ET may be used to predict the clinical outcome in women with infertility,and the increase of exogenous estrogen and progesterone in patients with low estrogen and progesterone cannot improve their clinical outcome.