卵巢不同反应性患者扳机日孕酮水平的研究进展

Advances in progesterone levels on the trigger day in patients with different ovarian response

孕酮在卵泡发育、胚胎着床和维持妊娠过程中发挥着重要的生理作用,是辅助生殖助孕治疗过程中重要的预测指标之一。控制性促排卵过程中扳机日孕酮水平升高会对临床妊娠结局产生负面影响,但关于孕酮水平升高的具体机制及影响方式仍不明确。近年来还有研究发现不同的卵巢反应性可能会影响扳机日孕酮水平升高与IVF-ET妊娠结局,因此,关于孕酮水平升高的阈值界定以及是否应针对不同卵巢反应性的人群来设定阈值的观点尚不统一。本文对扳机日孕酮水平升高的具体机制、其对辅助生殖技术妊娠结局的影响、阈值设定以及孕酮/获卵数这一指标对于妊娠结局的预测价值等内容进行综述,以期为进一步改善助孕治疗的临床妊娠结局提供更多思路和参考。

Progesterone plays an important physiological role in follicular development,embryo implantation and pregnancy maintenance,and is one of the important predictive indexes in assisted reproductive therapy.The increase of progesterone level on the trigger day during controlled ovulation induction will have a negative impact on clinical pregnancy outcomes,but the specific mechanism and the mode of elevated progesterone level is still unclear.In recent years,it has been found that different ovarian response may affect the elevated progesterone level on the trigger day and the pregnancy outcomes of IVF-ET.Therefore,the definition of the threshold of elevated progesterone level and whether the threshold should be set for people with different ovarian response are not unified.This article reviews the specific mechanism of the increase of progesterone level on the trigger day,its influence on the pregnancy outcomes of assisted reproductive technology,the setting of threshold and the predictive value of progesterone level/the number of oocytes retrieved for pregnancy outcomes,in order to provide more ideas and references for further improving the clinical pregnancy outcomes of assisted pregnancy treatment.