卵泡成熟前血清孕酮升时间与IVE/ICEI-ET妊娠结局

目的：探讨注射人绒毛膜促性腺激素（hCG）日之前血清孕酮升高时间对体外受精（IVF）/胞浆内单精子注射（ICSI）-胚胎移植（ET）患者妊娠结局的影响。方法：回顾性分析郑州大学第一附属医院生殖中心2012年6月-2013年6月经IVF/ICSI-ET治疗共2905例患者的临床资料。长方案组根据注射hCG日有无直径≥20 mm卵泡分为A组（2725例）和B组（180例），2组又根据自促排卵日至注射hCG日血清孕酮浓度＞1 ng/mL（1 ng/mL=3.17 nmol/L）时间分为以下3组：孕酮＞1 ng/mL 0 d者分别为A1组（1788例）和B1组（83例）；孕酮≥1 ng/mL 1～2 d者分别为A2组（717例）和B2组（67例）；孕酮≥1 ng/mL时间≥3 d者分别为A3组（220例）和B3组（30例）。比较各组间的妊娠率。结果：A1、A2、A3组妊娠率分别为55.42%、44.21%和41.81%，差异有统计学意义（P＜0.01）。B1、B2、B3组妊娠率分别为48.19%、47.76%和46.66%，差异无统计学意义（P＞0.05）。结论：IVF/ICSI-ET，hCG日存在直径≥20 mm的卵泡时，随着血清孕酮浓度升高（＞1 ng/mL）时间的增加，临床妊娠率会下降。

Days of the Elevated Level of Serum Progesterone before Follicular Maturation are Related with Outcomes of IVF/ICSI-ET Treatment

Objective：To explore the effect of days of the elevated serum progesterone before hCG administration on the outcomes of IVF/ICSI-ET treatment. Methods：2 905 cases of IVF/ICSI -ET treatment, from June 2012 to June 2013, were divided into two groups according to whether finding the follicle （s） of diameter≥20 mm （Group A 2 725 cases, and Group B 180 cases） on the hCG day. Two groups were respectively divided into 3 subgroups according to days of the elevated level of progesterone （〉1 ng/mL）. Group A1 （1 788 cases） and B1 （83 cases） had 0 day of the elevated level of progesterone. Group A2 （717 cases） and B2 （67 cases） had 1-2 days of the elevated level of progesterone. Groups A3 （220 cases） and B3 （30 cases） had ≥3 days of the elevated level of progesterone. The clinical pregnancy rates of groups were meticulously compared. Results：There was significant difference in the clinical pregnancy rates among the Group A1 （55.42%）, A2 （44.21%） and A3 （41.81%, P〈0.01）. Interestingly, there was no significant difference in those rates among the Group B1 （48.19%）, B2 （47.76%） and B3 （46.66%, P〉0.05）. Conclusions：The clinical pregnancy rate could decrease following days of the elevated level of serum progesterone （〉1 ng/mL） in those IVF/ICSI-ET patients with the follicle（s） of diameter≥20 mm on the hCG day.