胚胎移植日血清雌激素下降幅度对体外受精-胚胎移植结局的影响

目的:探讨黄体期雌激素下降幅度对IVF-ET后胚胎种植率和临床妊娠率的影响。方法:回顾性分析97个接受长方案控制性超排卵及IVF-ET治疗周期分别测定其hCG日和ET日血清E2水平,根据其下降幅度分为6组。A组:12个治疗周期,E2下降幅度<20%;B组:13个治疗周期,E2下降幅度20%-29%;C组:11个治疗周期,E2下降幅度30%-39%;D组:16个治疗周期,E2下降幅度40%-49%;E组:24个治疗周期,E2下降幅度50%-59%;F组:21个治疗周期,E2下降幅度≥60%。结果:ET日E2水平呈不同程度的下降,当下降幅度≥30%时胚胎种植率和妊娠率明显降低,差异出现显著性(P<0.05)。结论:长方案COH及IVF-EF中,ET日E2水平下降幅度≥30%时会引起胚胎种植率和临床妊娠率的降低,应考虑给予雌激素的补充。

Effect of Serum Estradiol Level Down-range on the Day of Embryo Transfer on in-vitro Fertilization Outcome

Objective: To study the effect of the serum estradiol level down-range on the day of embryo transfer on in-vitro fertilization outcomes. Methods: In this study 97 IVF-ET cycles were evaluated retrospectively. Serum estadiol was measured on the day of hCG administration and the day of embryo transfer(ET). They were divided into six groups according to the down-range of serum estradiol level on ET day, group A (<20%, 12 cycles), group B (20%-29%, 13 cycles), group C (30%-39%, 11 cycles), group D (40%-49%, 16 cycles), group E (50%-59%, 24 cycles), group F (≥60%, 21 cycles). Results: The estradiol concentration had the different down level on the day of ET. When the down-range of the estradiol on ET day was more than 30%, the embryo implantation rate and the clinical pregnancy rate were significantly lower (P<0.05). Conclusion: In IVF cycle, the rapidly decline of the serum estradiol has the important effection on the IVF-ET outcome. When the down-range of the serum estradiol is more than 30% from hCG day to ET day, the proper supplementation of estradiol during luteal phase might be necessary .