预估卵巢正常反应人群促排卵第5日血清E2水平与卵巢反应性

The correlation between the estradiol level of women with estimated normal ovarian response on day 5 after controlled ovarian hyperstimulation and their actual ovarian response

目的:探讨预估为卵巢正常反应人群促性腺激素(Gn)刺激第5日不同血清雌二醇(E2)水平与卵巢实际反应。方法:回顾性分析2015年1月—2017年9月在北京朝阳医院生殖中心就诊的预估为卵巢正常反应患者资料,以长方案促排卵行体外受精-胚胎移植(IVF-ET),检测Gn刺激第5日血清E2水平,将患者分为E2≥1460pmol/L组、>730pmol/L~<1460pmol/L、≤730pmol/L组,比较卵巢低反应和高反应的发生风险。结果:随着第5日血清E2值升高,卵巢过度刺激综合征(OHSS)的发生率升高(3.6%、5.7%、16.9%)(P<0.05)。Gn刺激第5日血清E2≤730pmol/L组卵巢低反应的发生率最高(53%)(P>0.05)。结论:对预估为卵巢正常反应的人群,Gn刺激第5日血清E2水平对OHSS和卵巢低反应的发生有提示作用。

Objective:To explore the correlation between the estradiol(E2)level of women with estimated normal ovarian response on day 5 after controlled ovarian hyperstimulation(COH)and their actual ovarian response.Method:Methods:The data of women with estimated normal ovarian response who wanted in vitro fertilization and embryo transfer(IVF-ET)between January 2015 and September 2017 were retrospectively analyzed.The included women had accepted GnRH agonist long protocol as for COH,and their E2 level on the 5 day after COH was detected.All the women were divided into three groups based on the value of E2 level,which included women with E2 level equal to or over 1460 pmol/L were in group A,women with E2 level from 730 pmol/L to 1460 pmol/L were in Group B,and women with E2 level equal to or less than 730 pmol/L were in group C.The risk rate of poor or high ovarian response ovarian response of women was compared among the three groups.Results:The rate of high ovary response of women in group A(35.6%)and B was significant higher than that of women in group C,but there was no statistical significance different among the three groups(P>0.05).As the E2 level increased on the 5 day after COH,the rate(3.6%,5.7%,and 16.9%,respectively)of ovarian hyper-stimulation syndrome(OHSS)increased gradually,and there was statistical significance different in the rate of OHSS among the three groups(P<0.05).The rate of poor ovary response of women in group C was highest(53%),and there was statistical significance different in the rate of poor ovary response among the three groups(P>0.05).Conclusion:For women who were estimated having normal ovarian response,E2 level on the 5 day of COH can be as a good predictor for identify the actual ovarian response.