Iodine Nutrition, Thyroid-stimulating Hormone, and Related Factors of Postpartum Women from three Different Areas in China: A Cross-sectional Survey

Objective Studies on the relationship between iodine,vitamin A(VA),and vitamin D(VD)and thyroid function are limited.This study aimed to analyze iodine and thyroid-stimulating hormone(TSH)status and their possible relationships with VA,VD,and other factors in postpartum women.Methods A total of 1,311 mothers(896 lactating and 415 non-lactating)from Hebei,Zhejiang,and Guangxi provinces were included in this study.The urinary iodine concentration(UIC),TSH,VA,and VD were measured.Results The median UIC of total and lactating participants were 142.00µg/L and 139.95µg/L,respectively.The median TSH,VA,and VD levels in all the participants were 1.89 mIU/L,0.44μg/mL,and 24.04 ng/mL,respectively.No differences in the UIC were found between lactating and non-lactating mothers.UIC and TSH levels were significantly different among the three provinces.The rural UIC was higher than the urban UIC.Obese mothers had a higher UIC and a higher prevalence of excessive TSH.Higher UICs and TSHs levels were observed in both the VD deficiency and insufficiency groups than in the VD-sufficient group.After adjustment,no linear correlation was observed between UIC and VA/VD.No interaction was found between vitamins A/D and UIC on TSH levels.Conclusion The mothers in the present study had no iodine deficiency.Region,area type,BMI,and VD may be related to the iodine status or TSH levels.

Effect of TSH Suppression Therapy on Sex Hormone Levels after Thyroid Cancer Surgery

Objective:To analyze the effect of thyroid-stimulating hormone(TSH)suppression therapy on sex hormone levels in patients undergoing postoperative treatment for thyroid cancer.Methods:A total of 40 patients undergoing postoperative thyroid cancer treatment were selected for data analysis.TSH suppression therapy was implemented during the postoperative period.Patients were grouped according to the TSH level:TSH<0.1,0.1≤TSH<0.5,and TSH≥0.5.Results:Among male patients,there were no significant differences in sex hormone levels at different dosing times and TSH levels(P>0.05).For female patients,testosterone levels at different dosing times showed no significant differences under the same circumstances(P>0.05).The comparison of testosterone levels at different TSH levels over 5 years of TSH suppression therapy did not yield significant differences(P>0.05).However,the comparison of testosterone levels within 5 years of TSH suppression therapy yielded significant differences(P<0.05),with the lowest levels observed at 0.1≤TSH<0.5.Conclusion:The use of TSH suppression therapy in postoperative thyroid cancer treatment minimally affects sex hormone levels in male patients.However,it has a significant impact on female patients.Therefore,preoperative sex hormone testing is recommended,and postoperative monitoring should include regular sex hormone testing.

Analysis of the value and safety of thyroid-stimulating hormone in the clinical efficacy of patients with thyroid cancer

BACKGROUND Thyroid cancer(TC)is a common malignant tumor in the endocrine system.In recent years,the incidence and recurrence rates of TC have been raising due to increasing work pressure and irregular lifestyles.Thyroid-stimulating hormone(TSH)is a specific parameter for thyroid function screening.This study aims to explore the clinical value of TSH in regulating the progression of TC,so as to find a breakthrough for the early diagnosis and treatment of TC.AIM To explore the value and safety of TSH in the clinical efficacy of patients with TC.METHODS 75 patients with TC admitted to the Department of Thyroid and Breast Surgery of our hospital from September 2019 to September 2021 were selected as the observation group,and 50 healthy subjects were selected as the control group during the same period.The control group was treated with conventional thyroid replacement therapy,and the observation group was treated with TSH suppression therapy.The soluble interleukin(IL)-2 receptor(sIL-2R),IL-17,IL-35levels,free triiodothyronine(FT3),free tetraiodothyronine(FT4),CD3+,CD4+,CD8+,CD44V6,and tumor supplied group of factor(TSGF)levels were observed in the two groups.The occurrence of adverse reactions was compared between the two groups.RESULTS After treatment with different therapies,the levels of FT3,FT4,CD3+,and CD4+in the observation group and the control group were higher than those before treatment,while the levels of CD8+,CD44V6,and TSGF were lower than those before treatment,and the differences were statistically significant(P<0.05).More importantly,the levels of sIL-2R and IL-17 in the observation group were lower than those in the control group after 4 wk of treatment,while the levels of IL-35 were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of FT3,FT4,CD3+,and CD4+in the observation group were higher than those in the control group,and the levels of CD8+,CD44V6,and TSGF were lower than those in the control group.There was no significant difference in the overall incidence rate of adverse reactions between the two groups(P>0.05).CONCLUSION TSH suppression therapy can improve the immune function of patients with TC,lower the CD44V6 and TSGF levels,and improve serum FT3 and FT4 levels.It demonstrated excellent clinical efficacy and a good safety profile.

Correlation analysis of serum thyroglobulin,thyroid-stimulating hormone levels,and thyroid-cancer risk in thyroid nodule surgery

BACKGROUND Thyroglobulin(Tg)is one of the markers of thyroid cancer,and its concentration may be elevated in patients with malignant thyroid tumors.Thyroid-stimulating hormone(TSH)is secreted by the pituitary gland,which has a significant impact on thyroid gland function.Excessively high or low TSH levels may be associated with an increased risk of thyroid cancer.Thus,in-depth studies on the association of serum Tg and TSH levels with thyroid cancer risk in patients with thyroid nodules are warranted.This can help determine whether Tg and TSH levels can predict the degree of malignancy of thyroid nodules,which can in turn guide doctors in making accurate diagnoses and treatment decisions.Furthermore,such studies can provide more accurate diagnostic methods for thyroid nodules and help patients become aware of the presence of thyroid cancer as early as possible,thereby improving the success rate of treatment and prognosis.AIM To investigate the association of serum Tg and TSH levels with the risk of thyroid cancer in patients undergoing thyroid nodule surgery.METHODS The clinical data and laboratory examination results of 130 patients who underwent thyroid nodule surgery were retrospectively analyzed.Furthermore,their preoperative serum Tg and TSH levels were recorded.Histopathological examination conducted during follow-up revealed the presence of thyroid cancer.Correlation analysis were used to analyze the association of Tg and TSH levels with the risk of thyroid cancer.RESULTS Of the 130 patients,60 were diagnosed with thyroid cancer.Statistical analysis revealed a significant positive correlation between serum Tg levels and the risk of thyroid cancer(P<0.05).This suggests that high serum Tg levels are associated with an increased risk of thyroid cancer.However,no significant correlation was observed between serum TSH levels and the risk of thyroid cancer(P>0.05).CONCLUSION In patients who underwent thyroid nodule surgery,serum Tg levels exhibited a significant correlation with the risk of thyroid cancer but serum TSH levels did not.These findings suggest that serum Tg can serve as an important biomarker for assessing the risk of thyroid cancer in these patients.

Comprehensive treatment of thyroid-stimulating hormone(TSH)-secreting pituitary adenoma:one case report

Thyroid-stimulating hormone(TSH)-secreting pituitary adenoma is a rare type in all pituitary tumors.Recently we treated a TSH-secreting pituitary tumor in our hospital.The patient had been treated for hyperthyroidism,in which methimazole had been prescribed for 10 years,but the symptoms had not been alleviated.MRI imaging demonstrated the typical features of a sellar tumor,and the diameter was approximately 2.7 cm.Based on the laboratory studies:T3 at 6.27 nmol/L,T4 at 260.10 nmol/L,FT3 at 17.22 pmol/L,FT4 at 76.06 pmol/L,TSH at 9.93 Mu/L,the patient was diagnosed with a TSH-secreting pituitary tumor and central hyperthyroidism.After the patient was given octreotide for one week,he received resection of tumor via single-nostril transsphenoidal approach.After discharge,the patient received the radiation therapy two courses about 20 days.Through the comprehensive treatment of surgery,radiotherapy and drugs,the patient received a satisfactory result.

Pituitary Suppression before Frozen Embryo Transfer Is Beneficial for Patients Suffering from Idiopathic Repeated Implantation Failure

Long-term gonadotropin-releasing hormone agonist（Gn RHa） administration before in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI） in infertile women with endometriosis or adenomyosis significantly enhanced the chances of pregnancy in both fresh and frozen embryo transfer cycles. We hypothesized that long-term Gn RHa treatment might also be beneficial for the idiopathic repeated implantation failure（RIF） patients. In the 21 patients receiving Gn RHa and hormone replacement therapy（G-HRT） protocols for frozen embryo transfer, their data were compared with those of the 56 of frozen/fresh cycles they had previously undergone（previous protocols）. Comparison showed that the finial results were significantly better with G-HRT protocols than with their previous protocols, with pregnancy rate, clinical pregnancy rate, implantation rate and on-going pregnancy rate being 70%, 60%, 40% and 38% respectively with G-HRT protocols, against 17%, 11%, 6.3% and 5% with previous protocols. The results showed that hormonally controlled endometrial preparation with prior Gn RHa suppression could be used for patients who had experienced repeated failures of IVF treatment despite having morphologically optimal embryos, and the treatment may help increase the receptivity of the endometrium in these patients.

Does Lower Dose of Long-acting Triptorelin Maintain Pituitary Suppression and Produce Good Live Birth Rate in Long Down-regulation Protocol for In-vitro Fertilization?

The effects of pituitary suppression with one-third depot of long-acting gonadotropin-releasing hormone（Gn RH） agonist in Gn RH agonist long protocol for in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI） were investigated. A retrospective cohort study was performed on 3186 cycles undergoing IVF/ICSI with Gn RH agonist long protocol in a university-affiliated infertility center. The pituitary was suppressed with depot triptorelin of 1.25 mg or 1.875 mg. There was no significant difference in live birth rate between 1.25 mg triptorelin group and 1.875 mg triptorelin group（41.2% vs. 43.7%）. The mean luteinizing hormone（LH） level on follicle-stimulating hormone（FSH） starting day was significantly higher in 1.25 mg triptorelin group. The mean LH level on the day of human chorionic gonadotrophin（h CG） administration was slightly but statistically higher in 1.25 mg triptorelin group. There was no significant difference in the total FSH dose between the two groups. The number of retrieved oocytes was slightly but statistically less in 1.25 mg triptorelin group than in 1.875 mg triptorelin group（12.90±5.82 vs. 13.52±6.97）. There was no significant difference in clinical pregnancy rate between the two groups（50.5% vs. 54.5%）. It was suggested that one-third depot triptorelin can achieve satisfactory pituitary suppression and produce good live birth rates in a long protocol for IVF/ICSI.

Thyroid-stimulating hormone-thyroid hormone signaling contributes to circadian regulation through repressing clock2/npas2 in zebrafish

Thyroid-stimulating hormone(TSH)is important for the thyroid gland,development,growth,and metabolism.Defects in TSH production or the thyrotrope cells within the pituitary gland cause congenital hypothyroidism(CH),resulting in growth retardation and neurocognitive impairment.While human TSH is known to display rhythmicity,the molecular mechanisms underlying the circadian regulation of TSH and the effects of TSH-thyroid hormone(TH)signaling on the circadian clock remain elusive.Here we show that TSH,thyroxine(T4),triiodothyronine(T3),and tshba display rhythmicity in both larval and adult zebrafish and tshba is regulated directly by the circadian clock via both E′-box and D-box.Zebrafish tshba^(−/−)mutants manifest congenital hypothyroidism,with the characteristics of low levels of T_(4)and T_(3)and growth retardation.Loss or overexpression of tshba alters the rhythmicity of locomotor activities and expression of core circadian clock genes and hypothalamic-pituitary-thyroid(HPT)axis-related genes.Furthermore,TSH-TH signaling regulates clock2/npas2 via the thyroid response element(TRE)in its promoter,and transcriptome analysis reveals extensive functions of Tshba in zebrafish.Together,our results demonstrate that zebrafish tshba is a direct target of the circadian clock and in turn plays critical roles in circadian regulation along with other functions.

Efficacy of the long-acting octreotide formulation in patients with thyroid-stimulating hormone-secreting pituitary adenomas after incomplete surgery and octreotide treatment failure

Background Little information about the current management of patients with thyroid-stimulating hormone （TSH）-secreting pituitary adenomas or about the usefulness of the somatostatin analogue octreotide was contained in the literature. This study aimed to report the efficacy and safety of the long-acting octreotide formulation in patients with TSH-secreting pituitary adenomas after incomplete surgery and octreotide treatment failure. Methods Fifteen patients with TSH-secreting pituitary adenomas （8 men and 7 women）, who previously underwent incomplete surgical resection and/or adjuvant radiotherapy （n=12） and failure of octreotide treatment （n=15）, followed between 2007 and 2010 in Beijing Tiantan Hospital were included in this study. All patients received 1- to 2-months of the long-acting octreotide formulation treatment after the above combination of treatment. Paired samples t-test was used to analysis the variables. Results After two-month duration of the long-acting octreotide formulation treatment, the mean serum free or unbound thyroxine （FT4） （（16.02±1.72） pmol/L） and free triiodothyronine （FT3） （（2.87±0.43） pmol/L） levels of 15 patients significantly decreased compared with those after octreotide-treatment （FT4, （35.36±7.42） pmol/L, P 〈0.001; FT3, （17.85±7.22） pmol/L, P 〈0.001）. Mean TSH levels stayed in the normal range after the long-acting octreotide formulation treatment （（0.72±0.21） mUlL） and were significantly lower than the pretreatment value （（5.27±1.04） mUlL, P 〈0.001）, post-surgery value （（3.37±0.31） mU/L, P 〈0.001） and post-octreotide-treatment value （（4.52±0.41） mU/L, P 〈0.001）. In these patients with TSH-secreting pituitary adenomas there was no evidence of tachyphylaxis. Conclusion The long-acting octreotide formulation may be a useful and safe therapeutic tool to facilitate the medical treatment of TSH-secreting pituitary adenomas in patients who underwent incomplete surgery or need long-term somatostatin analog therapy.

Enzyme-loaded liposome with biocatalytic precipitation for potentiometric immunoassay of thyroid-stimulating hormone in thyroid carcinoma

A simple and feasible potentiometric immunosensing platform based on enzymatic biocatalytic precipitation technique was designed for the sensitive detection of thyroid-stimulating hormone(TSH;a typical kind of biomarkers for thyroid carcinoma),using horseradish peroxidase(HRP)-loaded liposome for the signal amplification.To construct such an assay system,a sandwich-type immunoreaction was readily carried out on monoclonal anti-TSH capture antibody-coated electrode by using polyclonal antiTSH secondary antibody-conjugated HRP-loaded liposome.Accompanying the formation of sandwichtype immunocomplex,the carried liposome was lysed through the added Triton X-100 to release the entrapped HRP molecules,which catalyzed the oxidation of 4-chloro-1-naphthol to produce an insoluble and uncharged organic precipitation on the electrode surface,thereby causing the change of the local electrical potential.Two labeling protocols with and without the liposome were investigated for detection of target TSH,improved analytical features were achieved with HRP-entrapped liposome.Under optimal conditions,the potentiometric immunosensor had good responses for TSH detection within the linear range of 0.01-30 p IU/mL at a detection limit of 0.0067 p IU/mL.Good reproducibility,high specificity and long-time stability were acquired during the assay procedure.Importantly,a wellmatched accuracy between the potentiometric immunosensor and commercial human TSH ELISA kit was gave for the analysis of human serum samples.

The effects of thyroid-stimulating hormone,estradiol and prolactin on sodium/iodide symporter mRNA expression in mouse lactating mammary gland cells under different iodine levels

Objective The present study investigated the sodium/iodide symporter mRNA expression in mouse lactating mammary gland cells under different iodine levels and the effects of thyroid-stimulating hormone(TSH),estradiol(E2)and prolactin(PRL)on NIS mRNA expression in mouse lactating mammary gland cells.

奥曲肽抑制试验在肢端肥大症中的特征研究及应用

目的:探讨奥曲肽抑制试验(OST)在肢端肥大症中的特征及其对疾病诊治的应用价值。方法:选取2019年12月—2022年12月在天津医科大学总医院内分泌代谢科治疗的28例肢端肥大症患者(其中20例患者已行外科手术且术后病理报告为垂体生长激素瘤)行OST,计算0.5、1、1.5、2、4、6、8、10、12、16和24 h各时间点的生长激素(GH)抑制率,对6例应用生长抑素类似物(SSA)治疗的患者进行随访,分析患者在接受长效SSA治疗前后的GH、胰岛素样生长因子-1(IGF-1)水平的下降情况,并评估OST在肢端肥大症患者接受长效SSA治疗的预测效果。结果:肢端肥大症患者在实验室生化检查时的GH、IGF-1水平均高于正常范围,行OST期间除了5例患者GH最高抑制率小于50%,其余患者均大于50%,且有12例患者抑制率大于75%。GH抑制率达到最高点时所需平均时间为(3.1±1.0)h,与患者基础GH水平不存在明显相关性(r=-0.196,P=0.467),同时抑制率达到最高点时的GH水平与患者基础GH水平无明显相关性(r=-0.187,P=0.488)。接受醋酸奥曲肽微球治疗患者的GH、IGF-1水平均有显著下降,降低率分别为(58.58±15.20)%、(35.79±15.69)%,行OST期间患者GH最高抑制率与接受醋酸奥曲肽微球治疗患者GH抑制率不存在显著性差异(z=-1.32,P=0.207)。结论:OST具有创伤小、不良反应发生率低、操作安全性高、相对经济有效的特征,可指导肢端肥大症患者后续药物治疗,在肢端肥大症的诊疗中有重要参考价值。

两种雌孕激素替代法内膜准备对多囊卵巢综合征冷冻胚胎移植临床效果的比较

目的比较非降调节雌孕激素替代法与降调节雌孕激素替代法作为子宫内膜准备方法对多囊卵巢综合征患者(PCOS)冻融胚胎移植(FET)的妊娠结局。方法在PCOS患者FET周期中,分别采用非降调节雌孕激素替代法(n=89)、降调节雌孕激素替代法(n=37)准备内膜,比较周期妊娠率、种植率、流产率、宫外孕发生率等指标。结果两组患者年龄分别为(29.53±3.39)岁和(29.24±2.85)岁(P>0.05);基础体质量指数分别为(23.07±3.51)和(22.20±2.96)(P>0.05);不孕年限分别为(3.14±1.89)年和(3.86±1.36)年(P>0.05);两组移植周期临床妊娠率为55.06%和72.9%(P<0.05);种植率分别为38.7%和53.6%(P<0.05);流产率分别为16.3%和14.8%(P>0.05);宫外孕率分别为4.1%和3.7%(P>0.05)。结论对于PCOS患者使用降调节雌孕激素替代法是一种合适的子宫内膜准备方案。

结节性甲状腺肿术后促甲状腺激素抑制治疗效果的探讨

目的:观察结节性甲状腺肿患者手术后在不同时间给予抑制治疗后促甲状腺激素(TSH)水平的变化和2年后的复发率,探讨给予TSH抑制治疗的最佳时机。方法:将120例结节性甲状腺肿术后患者分为对照组(n=60)和实验组(n=60),对照组术后3周开始给药,实验组在术后第1d开始给药,药物为左甲状腺素,剂量均为100μg/d,每天早晨空腹顿服。于术后第3d、第5d、第9d、第14d及每个月检测血清促甲状腺激素(血清s-TSH)水平,比较2组TSH值的变化及其复发率。结果:与对照组相比,实验组术后s-TSH水平较早达到平稳(P<0.05),且其术后2年的复发率显著低于对照组(P<0.05)。结论:结节性甲状腺肿患者术后早期给予TSH抑制治疗能明显缩短其达到TSH平稳的时间,并且降低术后的复发率。

门控心肌灌注显像预测老年DTC患者TSH抑制治疗后心功能异常

目的探讨门控心肌灌注显像(GSMPI)预测接受促甲状腺激素(TSH)抑制治疗的60~64岁老年分化型甲状腺癌(DTC)患者心功能异常的价值。方法46例60~64岁老年DTC患者于甲状腺切除术后接受131 I治疗及TSH抑制治疗,并于甲状腺切除术后1个月、TSH抑制治疗12个月及18个月接受GSMPI检查,比较各时间点左心室心功能参数和心肌血流灌注情况差异。结果TSH抑制治疗后,高峰充盈率(PFR)由治疗前的(3.28±0.59)EDV/s下降至治疗12个月的(2.59±0.51)EDV/s及治疗18个月的(2.03±0.47)EDV/s(P均<0.05);其余GSMPI参数各时间点间差异均无统计学意义(P均>0.05)。结论GSMPI测量PFR可预测60~64岁老年DTC患者心功能障碍;TSH抑制治疗1年后患者左心室舒张功能下降,且随治疗时间延长,心功能异常持续加重。

抗米勒管激素用于年轻乳腺癌患者卵巢功能抑制个体化治疗的评价

背景与目的:年轻乳腺癌患者应用促黄体生成素释放激素类似物戈舍瑞林治疗没有个体化用药方案,并缺乏临床可用的指导依据。该研究皆在探讨抗米勒管激素(anti-Müllerian hormone,AMH)在年轻乳腺癌患者卵巢功能抑制个体化治疗的评价作用。方法:选取2012年5月—2014年1月在上海交通大学附属仁济医院因雌激素受体(estrogen receptor,ER)和孕激素受体(progesterone receptor,PR)阳性的乳腺癌41例患者,术前随机分为戈舍瑞林6个疗程+化疗组(简称戈舍瑞林组)20例,化疗组21例,30例同年龄组健康妇女为正常对照组,随访(17.4±6.2)个月。观察两组治疗后的停经时间与复潮时间,于术前1个月、戈舍瑞林组或化疗组术后月经复潮后3、6个月检测AMH、促卵泡激素(follicle-stimulating hormone,FSH)和E_2水平。正常对照组在相应时间段内检测AMH、FSH和E_2水平。结果:3组患者的术前临床资料及术前FSH、E_2水平差异均无统计学意义(P>0.05),乳腺癌患者术前AMH水平较正常对照组降低,差异有统计学意义(P=0.04);戈舍瑞林组较化疗组停经时间更短,差异有统计学意义(P=0.00);戈舍瑞林组较化疗组复潮时间更短,差异有统计学意义(P=0.00);与正常对照组及术前比较,戈舍瑞林组及化疗组FSH、E_2水平在5个测定时间的差异均无统计学意义(P>0.05);戈舍瑞林组及化疗组在5个测定时间的AMH水平均显著降低,差异均有统计学意义(P=0.00),两组在复潮后3、6个月AMH水平逐渐上升,差异均有统计学意义(P<0.05);与化疗组相比,戈舍瑞林组的AMH水平下降明显,戈舍瑞林组的AMH水平在复潮6个月后比化疗组升高,差异均有统计学意义(P<0.05)。结论:年轻乳腺患者在卵巢功能抑制治疗+化疗过程中,AMH较其他评价卵巢储备的指标明显下降,在其他指标恢复术前水平后仍提示卵巢受损,提示AMH可以作为评价年轻乳腺癌患者卵巢功能的指标,亦有可能成为戈舍瑞林个体化治疗的评价指标。

结节性甲状腺肿术后甲状腺激素水平的变化及其对抑制治疗的意义

目的:研究结节性甲状腺肿(甲肿)患者甲状腺切除术后血清甲状腺激素水平的变化,探讨术后抑制治疗的起始时间、剂量与腺体切除范围的关系。对象与方法:26例女性甲肿患者分为单侧切除组(n=17)和双侧切除组(n=9),术前、术后第五天和术后3周分别检测血清甲状腺激素水平,配对比较前后变化。术后予甲状腺片对s-TSH作部分抑制治疗。结果:单侧切除组术后第五天,T_4、FT_4(P<0.05)较术前升高,s-TSH明显降低(P<0.01),但术后3周与术前比较无明显变化。双侧切除组术后甲状腺激素水平呈逐渐下降,至术后3周T_4、FT_4较术前明显降低(P<0.05)。两组服抑制剂量的甲状腺片分别平均为42.7mg/d±12.79mg/d和67.5mg/d±14.9mg/d(P<0.01)。结论:术后短期甲状腺激素水平变化与腺体切除范围有关。术后两周内不宜开始抑制治疗。单侧切除组所需抑制性外源甲状腺激素较双侧切除组量少,s-TSH水平监测有助于药量调整,以避免抑制不足或过分抑制。

降调节与非降调节激素替代内膜准备对冻融胚胎移植结局的影响

目的:比较3.75mg GnRHa降调节激素替代内膜准备方案与单纯激素替代内膜准备方案对冻融胚胎移植(FET)妊娠率的影响。方法:选取1225例(周期)行冻融胚胎移植患者,根据内膜准备方式分为激素替代周期组(A组)417例和降调节激素替代组808(B组)例。比较两组患者的种植率、妊娠率、流产率和生殖激素水平。结果:激素替代周期组和降调节激素替代组患者的种植率分别为33.6%和38.1%,临床妊娠率分别为52.3%和58.8%;两组的种植率和临床妊娠率比较差异均有统计学意义(P<0.05)。降调节激素替代组的黄体酮注射日、ET前1日和ET后第3日LH低于A组,差异有统计学意义(P<0.05)。两组患者的流产率和异位妊娠率比较,差异无统计学意义(P>0.05)。结论:与传统激素替代内膜准备方案比较,3.75mg GnRHa降调节激素替代内膜准备方式可提高冻融胚胎移植妊娠率而不增加流产率。

控制性超排卵中黄体生成素的过度抑制和黄体生成素预处理

体外受精-胚胎移植(IVF-ET)降调方案中,使用促性腺激素释放激素激动剂(GnRH-a)降调后,部分患者可能出现卵巢过度抑制,对卵泡刺激素(FSH)的反应延迟。而GnRH-a主要抑制黄体生成素(LH),因此可能存在LH不足,对IVF中出现卵巢过度抑制的患者可考虑LH预治疗。

不同剂量促性腺激素释放激素激动剂长方案中黄体生成素水平变化及临床意义

不同剂型和剂量的促性腺激素释放激素激动剂(GnRH-a)对垂体的抑制程度不同,因而不同剂型和剂量的GnRH-a长方案中血清黄体生成素(LH)水平也有所不同,从而导致各种方案的临床特征不同。目前研究表明,与短效GnRH-a长方案相比,长效GnRH-a长方案中,促性腺激素(Gn)的使用时间和剂量明显增多,但是二者的临床结局,包括临床妊娠率、活产率、卵巢过度刺激综合征发生率等均无显著性差异。