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促性腺激素释放激素激动周期中人绒毛膜促性腺激素-日血清孕酮和雌二醇水平对妊娠结局的影响

Effect of HCG-day serum progesterone and oestradiol concentrations on pregnancy outcomes in GnRH agonist cycles
2012-07-13 09:57点击:58次发表评论
作者:Wu, Z.ab , Li, R.a , Ma, Y.b, Deng, B.b, Zhang, X.
机构: 北京大学第三医院生殖医学中心妇产科
期刊: REPROD BIOMED ONLINE2012年5月5期24卷

Department of Obstetrics and Gynecology, Reproductive Medical Centre, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing 100191, China

This study analysed the relationship between serum progesterone/oestradiol concentrations and IVF pregnancy outcomes in gonadotrophin-releasing hormone agonist protocols. A total of 2921 infertile women undergoing IVF were assigned to four groups according to serum progesterone and oestradiol concentrations on the day of human chorionic gonadotrophin (HCG) administration: group 1 (control) progesterone < 3.34 nmol/l and oestradiol < 19,124 pmol/l; group 2 (high oestradiol); group 3 (high progesterone); group 4 (high progesterone and high oestradiol). Compared with group 1, group 4 had lower clinical pregnancy and live birth rates as well as the highest ectopic pregnancy rate (29.15% versus 45.91%; 18.67% versus 34.34%; 18.10% versus 5.82%; P < 0.05). Group 3 had lower clinical pregnancy and live birth rates per embryo-transfer cycle (29.78% versus 45.91%; 20.28% versus 34.34%, respectively; P < 0.05). Clinical pregnancy rates were similar in frozen-thawed embryo transfers (FET) among the four groups. In conclusion, elevated progesterone was detrimental to live birth rates. High serum oestradiol concentration on HCG day did not affect the IVF pregnancy outcome. In combination with the elevated progesterone, high oestradiol concentrations had a potential negative effect. For these patients, FET should be suggested to improve the pregnancy outcomes. The aim of this study was to analyse the relationship between serum progesterone/oestradiol concentrations and IVF pregnancy outcomes in gonadotrophin-releasing hormone agonist protocols. A total of 2921 infertile women undergoing IVF were assigned to four groups according to their serum progesterone and oestradiol concentrations on the day of human chorionic gonadotrophin (HCG) administration: group 1 (control) progesterone < 3.34 nmol/l and oestradiol < 19,124 pmol/l; group 2 (high oestradiol); group 3 (high progesterone); group 4 (high progesterone and high oestradiol). Compared with group 1, patients in group 4 had lower clinical pregnancy (29.15% versus 45.91%) and live birth rates (18.67% versus 34.34%) as well as the highest ectopic pregnancy rate (18.1% versus 5.82%) (all P < 0.05). Those in group 3 had lower clinical pregnancy and live birth rates per embryo transfer cycle (29.78% versus 45.91%; 20.28% versus 34.34%, respectively, P < 0.05). Embryo quality appeared to be unaffected since similar clinical pregnancy rates in frozen-thawed embryo transfer (FET) cycles among the four groups. In conclusion, elevated progesterone was detrimental to live birth rates. A high serum oestradiol concentration on the day of HCG administration did not affect the IVF pregnancy outcome. In combination with the elevated progesterone and oestradiol concentrations had a potential negative effect. For these patients, FET should be suggested to improve the pregnancy outcomes. © 2012, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Qiao, J.; Department of Obstetrics and Gynecology, Reproductive Medical Centre, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing 100191, China; email: jie.qiao@263.net

通讯作者:Qiao, J.; Department of Obstetrics and Gynecology, Reproductive Medical Centre, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing 100191, China; email: jie.qiao@263.net
学科代码:妇产科学   关键词:促性腺激素释放激素激动周期中人绒毛膜促性腺激素-日血清孕酮和
来源: Scopus
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