生殖医学杂志2018，Vol.27Issue(6)：505-509,5.DOI:10.3969/j.issn.1004-3845.2018.06.001
长效GnRH-a降调促排方案HCG次日孕酮水平对IVF临床结局的影响
Impact of progesterone level after HCG administration on the outcome of IVF in long GnRH-agonist pituitary suppression protocol
摘要
Abstract
Objective:To explore the impact of the serum progesterone level after HCG administration on the outcomes of IVF-ET in long GnRH-agonist pituitary suppression protocol.Methods:The data of 941 cycles of IVF-ET in our center from 2014 to 2015 were retrospectively analyzed.The cycles were divided into 3 groups according to the different percentile cutoffs of serum progesterone (P) on the next day of HCG administration:group Ⅰ(P≤14.17 nmol/L),group Ⅱ(14.17 nmol/L＜ P＜ 46.16 nmol/L),group Ⅲ (P≥46.16 nmol/L).The clinical outcomes were compared among the three groups.Then 634 cycles of fresh embryo transplantation were further subdivided into 3 groups according to the abovementioned progesterone percentile cut-off values:group A(79 cycles),group B(532 cycles),group C(23 cycles).The clinical outcomes were compared among the three groups.Results:There were significant differences in gonadotropin(Gn)dosage used,E2 & P levels on HCG day,number of mature oocytes,and number of available embryos among the group Ⅰ,Ⅱ and Ⅲ (P＜0.001).IVF normal fertilization rate was not significantly different among the 3 groups(P＞0.05).The Gn doses & days used,E2 & P levels on HCG day,mature oocytes,and number of available embryos in groups A,B,and C were similar to those in groups Ⅰ to Ⅲ[.The Gn doses used was the least,and E2 & P levels on HCG day,the number of mature oocytes and the number of available embryos were the highest in group C(P＜0.05).There was no significant difference in IVF fertilization rate,implantation rate,clinical pregnancy rate,live birth rate and miscarriage rate among the 3 groups(P＞0.05).There was a downward trend in fertilization rate and clinical pregnancy rate in group C,compared with group A & B.Conclusions:The serum progesterone level after HCG administration had no impact on clinical pregnancy rate in IVF,but too high progesterone level on the next day after HCG administration would decline the implantation rate and clinical pregnancy rate.Therefore,when the progesterone levels are significantly increased on the next day of HCG administration,it is necessary to carefully choose whether to perform fresh embryo transfer.关键词
孕酮/HCG日/IVF-ET/妊娠结局Key words
Progesterone/HCG day/IVF-ET/Clinical outcome引用本文复制引用
沈晓月,山惠枝,蒋玥,孔娜,孙海翔..长效GnRH-a降调促排方案HCG次日孕酮水平对IVF临床结局的影响[J].生殖医学杂志,2018,27(6):505-509,5.基金项目
国家自然科学基金青年科学基金项目(81601246) （81601246）
