两种控制下超排卵方案对IVF-ET结果的影响

目的 :探讨促性腺激素释放激素类似物 (GnRH a)两种长方案控制下超排卵对IVF ET结果的影响。方法 :回顾性分析比较IVF ET病人中两组降调节长方案的促性腺激素使用量 ,刺激天数 ,HCG日子宫内膜厚度 ,成熟卵泡数 ,取卵数 ,受精率 ,卵裂率 ,移植胚胎数 ,A级胚胎比率和妊娠率。结果 :两种降调节长方案组在促性腺激素使用量 ,刺激天数 ,hCG日子宫内膜厚度 ,成熟卵泡数 ,取卵数 ,受精率 ,卵裂率 ,移植胚胎数 ,A级胚胎比率和妊娠率差异均无显著意义。结论 :在IVF ET中 ,GnRH a卵泡早期降调节和黄体期降调节方案均能获得相同的控制性超排卵效果 ,且GnRH a卵泡早期降调节方案更安全、操作简单、方便。     

促性腺激素释放激素激动剂超长方案在反复体外受精失败患者治疗中的应用

目的 比较促性腺激素释放激素激动剂(GnRHa)超长方案在初次及反复体外受精-胚胎移植技术(IVF-ET)失败治疗周期中,患者对卵巢控制性促超排卵的反应情况及治疗结局,探讨超长方案应用的适应证选择及疗效.方法 回顾性队列研究2009年1月1日至12月31日在我院生殖医学中心进行GnRHa激动剂超长方案控制性促超排卵IVF-ET治疗的患者,共227个取卵周期,按是否接受过IVF-ET助孕治疗分为反复治疗失败组(组1,90个周期)及初次治疗组(组2,137个周期).比较两组控制性促超排卵后卵巢反应情况及IVF-ET结局.结果 组1患者年龄及不孕时间均显著高于组2患者(P＜0.05),两组基础血激素水平、窦卵泡数、Gn用量及天数均无统计学差异,临床妊娠率及胚胎种植率亦无统计学差异(分别为42.7％vs.40.5％,P=0.770及24.9％vs.23.2％,P=0.740).其中,反复IVF治疗失败患者超长方案后冻融胚胎移植周期临床妊娠率25.64％.结论 IVF-ET周期中,超长方案控制性促超排卵在反复IVF治疗失败的难治性IVF-ET患者中能获得满意的妊娠结局.     

两种促排卵方案在体外受精治疗中的应用

[目的]探讨两种促排卵方案在体外受精(IVF)治疗中的应用价值,寻求一种更有效的刺激方案.[方法]562例接受体外受精-胚胎移植(IVF-ET)助孕治疗的患者,262例采用wake-up方案为A组;300例采用stir-up方案为B组.比较两组的促性腺激素(Gn)使用天数、Gn使用总量、HCG日雌二醇(E2)值、获卵数、雌雄原核(2PN)受精卵数、卵裂数、优质胚胎数、临床妊娠率和胚胎种植率.[结果]两组获卵数、2PN受精卵数、卵裂数、优质胚胎数、临床妊娠率和胚胎种植率,A、B两组之间比较无显著差异(P>0.05).而A组与B组Gn使用天数、Gn使用总量、HCG日E2值,两组之间比较有显著差异(P<0.05).[结论]IVF治疗中采用stir-up方案促排卵较wake-up方案更经济、有效.     

生长激素辅助促排卵对卵巢低反应患者体外受精-胚胎移植结果的影响

【目的】探讨生长激素（GH）辅助促排卵治疗对预测卵巢低反应患者体外受精-胚胎移植（IVF-ET）结果的影响。【方法】选择2004年1月至2005年12月在本院生殖中心接受体外受精-胚胎移植88例卵巢低反应型患者，56例使用改良的短方案促排卵为对照组，32例使用改良的短方案同时加用生长激素辅助促排卵为研究组，分析其GH用量、获卵数、受精率、卵裂率、种植率、临床妊娠率。【结果】本中心行体外受精-胚胎移植治疗周期卵巢低反应型占8．51％，研究组Gn用量、用药时间略低于对照组，注射HCG当日E2水平、获卵数、受精率、卵裂率、种植率略高于对照组，但两组比较均差异无显著性（P〉0．05）；而研究组临床妊娠率明显高于对照组，差异有显著性（P〈0．05）。【结论】GH辅助促排卵治疗卵巢低反应患者可减少无可移植的胚胎周期，临床妊娠率有显著提高。     

促性腺激素释放激素拮抗剂在防治卵巢过度刺激综合征中的应用

目的探讨促性腺激素释放激素（GnRH）拮抗剂在预防和治疗体外受精-胚胎移植（IVF-ET）过程中并发卵巢过度刺激综合征（OHSS）的作用。方法选择我院生殖医学中心2011年1月至2013年6月接受IVF-ET助孕,HCG日血清雌二醇（E2）〉4000pg／ml且获卵数〉／20个而取消新鲜胚胎移植的患者44例,随机分为2组。对照组（n=23）予临床常规处理;拮抗剂组（n=21）在此基础上加用醋酸西曲瑞克0．25mg,每日一次,共7d。检测血清E2水平,计算OHSS、中重度OHSS的发生率。结果两组血清E2水平均逐步下降,而拮抗剂组治疗后第3、5、7天血清E2水平均低于对照组（P〈0．05）;拮抗剂组未出现OHSS的比例显著高于对照组（42．9％VS．13．0％,P=0．027）,而中重度OHSS的发生率明显低于对照组（23．8％VS．69．6％,P=0．001）。结论GnRH拮抗剂可以降低OHSS的发生比率、减少轻度向中重度OHSS发展。GnRH拮抗剂是预防和治疗IVF-ET中OHSS的有效措施之一。     

体外受精-胚胎移植前输卵管积水处理方式探讨

[目的]探讨输卵管积水不同处理方式对体外受精-胚胎移植(IVF-ET)结局的影响.[方法]因输卵管积水致不孕147例,共治疗155个周期,按输卵管积水的处理方法分为5组.A组:22个周期,输卵管积水未处理,直接行IVF-ET;B组:21个周期,术前切除积水输卵管;C组:22个周期,术前行输卵管伞端造口术;D组:19个周期,IVF-ET开始后口服强力霉素100 mg,每日两次10 d,取卵日抽吸输卵管积水,胚胎移植前一日发现宫腔有积液者立即行宫腔积液抽吸;E组:对照组,71个周期,输卵管阻塞无积水.[结果]各组间受精率、卵裂率、优质胚胎率、移植胚胎数比较差异均无显著性(P＞0.05).获卵数、种植率及临床妊娠率A组最低,与其余组比较差异有统计学意义(P＜0.05),而其余四组间差异无显著性(P＞0.05).异位妊娠率及流产率A组最高,其次为D组、C组;与B组、E组比较差异有显著性(P＜0.05).[结论]输卵管积水对IVF-ET的结局有负面影响,适当的处理有利于改善IVF-ET结局.     

影响体外受精-胚胎移植妊娠率因素分析

目的 :探讨影响体外受精—胚胎移植 (IVF ET)妊娠率的因素。方法 :对 12 9例 14 2个周期不孕患者采用常规促性腺激素释放激素 (GnRHa) /高纯度促卵泡生成素 (FSH HP) /绒毛膜促性腺激素 (HCG )刺激排卵方案 ,B超监测卵泡发育 ,经阴道B超引导下取卵 ,实验室体外培养受精 ,子宫腔内胚胎移植 ,并对影响妊娠因素进行分析。结果 :14 2个周期中妊娠 5 3个周期 ,非妊娠 89个周期 ,临床妊娠率 37 32 % ,妊娠及非妊娠两组的不孕年龄、年限、不孕原因、培养 48h≥ 4细胞C级以上的胚胎数 ,HCG日的促黄体生成素 (LH)及血清基础LH、泌乳素 (PRL)差异有显著意义 (P <0 0 5 )。卵巢过度刺激综合征发生率妊娠组大于非妊娠组 ,但两组差异无显著意义 (P >0 0 5 )。结论 :IVF ET妊娠成功率与不孕年龄、年限、不孕原因、胚胎质量、血清LH、PRL有关     

促性腺激素释放激素拮抗剂在体外受精-胚胎移植中有效性的系统性评价

目的系统性评价促性腺激素释放激素（GnRH）拮抗剂在体外受精-胚胎移植治疗中的有效性。方法计算机检索中国生物医学文献数据库（1979～2010）、万方数据库（1994～2010）、中国学术期刊网专题全文数据库（1994～2010）、中国生物医学期刊数据库（1989～2010）和PubMed（1997～2010）、ProQust MedicalLibrary（1997～2010）、外文生物医学期刊文献数据库（2000～2010）,并手检相关杂志,查找GnRH拮抗剂与GnRH激动剂比较在体外受精-胚胎移植治疗中有效性的随机对照试验。按照纳入与排除标准选择试验、评价质量后进行Meta分析。结果共纳入6个RCT,合计1208例患者,其方法学质量均为B级。Meta分析结果显示：与GnRH激动剂组相比,GnRH拮抗组刺激天数[WMD=–1.07,95%CI（–1.38,–0.76）]和获卵数[WMD=–1.80,95%CI（–2.48,–1.12）]均更低,差异有统计学意义;而在Gn量[WMD=–0.49,95%CI（–1.63,0.66）]、HCG日子宫内膜厚度[WMD=–0.09,95%CI（–0.42,0.24）]、妊娠率[Peto OR=0.83,95%CI（0.65,1.05）]、OHSS率[PetoOR=0.77,95%CI（0.35,1.72）]和流产率[Peto OR=1.49,95%CI（0.79,2.82）]上,两组差异均无统计学意义。结论 GnRH拮抗剂较之GnRH激动剂刺激天数短,所需Gn量少,不明显影响妊娠率,同时可减少OHSS的发生,临床上使用相对灵活,具有较好的接受性,为体外受精-胚胎移植超促排卵治疗提供了另一种选择。受纳入研究质量和例数限制,上述结论尚需开展更多设计严谨的多中心、大样本随机对照试验予以证实和更新。     

体外受精—胚胎移植治疗不孕症的临床研究附22个周期总结报告

我院于 1 999年 7月～ 2 0 0 0年 4月完成体外受精—胚胎移植 (ｉｎｖｉｔｒｏｆｅｒｔｉｌｉｚａｔｉｏｎ -ｅｍｂｒｙｏｔｒａｎｓｆｅｒ,ＩＶＦ -ＥＴ)周期 2 2个 ,现报告如下。1　临床资料与方法2 2例患者年龄 2 4～ 45岁 ,其中 >40岁 3例。原发性不孕 3例 ,继发性不孕 1 9例。不孕时间 1～ 1 4年 ,平均 5 1 8年。其中输卵管因素不孕 2 0例 ,分别经过输卵管通水结合Ｂ超检查、子宫输卵管碘油造影腹腔镜检查证实 ;另 2例为不明原因不孕。采用促性腺激素释放激素激动剂联合卵泡刺激素及人绒毛膜促性腺激素的长周期治疗方案(ＧｎＲＨ -ａ/…     

促性腺激素释放激素激动剂降调节后月经第3天血清黄体生成素值对体外受精-胚胎移植的影响

目的 经过促性腺激素释放激素激动剂(GnRHa)降调节后,在月经第3天使用促性腺激素(Gn)前对血清黄体生成素(LH)进行测定,探讨不同血清LH值与体外受精-胚胎移植(IVF-ET)结局的关系,以寻找合适的血清LH降调标准.方法 对2007年3月至2010年7月在海军总医院妇产科辅助生殖医学中心进行的254个取卵周期进行同顾性分析,按降调节后月经第3天血清LH值不同对254个周期进行分组,分析各组间实验室数据及临床妊娠率的差异.同时通过解冻周期胚胎存活率及临床妊娠率,进一步研究新鲜周期血清LH值对胚胎发育潜能的影响.结果 GnRHa降调节后,各组之间年龄、正常受精率、D3优质胚胎率、囊胚形成率、可利用胚胎率、移植胚胎数目没有统计学差异(P值分别为0.122、0.129、0.235、0.605、0.417、0.496),但各组间临床妊娠率差异有统计学意义(P=0.016).GnRHa降调节后不同血清LH值对胚胎的发育潜能无影响.结论 GnRHa降调节后,在月经第3天不同血清LH值对实验室数据及胚胎的发育潜能没有显著性影响,但对临床妊娠率影响显著,并初步认为当2 IU/L≤LH<4 IU/L时,可能会达到较为理想的新鲜周期妊娠结局.     

简化促性腺激素释放激素兴奋试验在女性性早熟症诊断中的意义

【目的】探讨简化促性腺激素释放激素（GnRH）兴奋试验在女性性早熟症诊断中的意义。【方法】采用电化学发光免疫法测定60例性早熟女孩基础血清卵泡刺激素（FSH）,黄体生成素（LH）,雌二醇（E2）水平及行GnRH刺激试验后,血清FSH,LH水平的变化情况．并进行比较。【结果】真性性早熟患儿的FSH,LH值明显升高,LH峰值均〉12IU／L;LH／FSH〉1;假性性早熟患儿LH,FSH值略升高,LH值均〈12IU／L,LH／FSH〈1。【结论】简化GnRH兴奋试验能够直接观察下丘脑-垂体-性腺轴功能状态,对鉴别真性性早熟和假性性早熟有重要意义。     

腹腔镜手术联合促性腺激素释放激素激动剂治疗中、重度内异症的疗效研究

【目的】探讨腹腔镜手术联合促性腺激素释放激素激动剂（GnRH-a）治疗中、重度子宫内膜异位症（内异症）的临床疗效。【方法】回顾性分析湖南省人民医院2010年3月至2013年3月收治的50例内异症患者临床资料。根据手术前后联合使用GnRH-a情况分为A和B两组。术前术后联合治疗组（A组）：15例,腹腔镜手术前皮下注射GnRH-a共2～3次,术后再注射3次;术后联合治疗组（B组）：35例,腹腔镜手术后皮下注射GnRH-a共3-6次。术后所有患者随访12个月。比较两组患者的手术时间、术中出血量、术后恢复情况、疼痛症状视觉模拟评分（VAS）、复发率及药物不良反应等指标。【结果】A组与B组手术时间分别为（65±12）min、（92±16）min;术中出血量分别为（105±12）mL、（190±29）mL ;A组患者术后下床活动时间及肛门排气时间均早于B组;治疗后随访至术后12个月,A组和B组VAS分别由术前3．7（1．7～6．5）分、3．2（1．4～6．4）分下降至1．6（1．0～3．6）分、1．6（1．1～3．5）分,A组和B组患者随访期间复发率分别为7％（1/15）、6％（2/35）,两治疗组之间比较无统计学意义。【结论】腹腔镜手术联合术前术后使用GnRH-a治疗中、重度内异症能够缩短手术时间、减少术中失血、促进术后恢复;但是,与术后联合使用GnRH-a在改善术后痛经、降低复发率方面效果相当。     

体外受精-胚胎移植在多囊卵巢综合征不孕患者的临床应用

[目的]探讨体外受精一胚胎移植(IVF-ET)或单精子卵胞浆内注射(ICSI)对多囊卵巢综合征(PCOS)合并不孕的治疗效果.[方法]对2003年5月至2006年5月在本院行IVF-ET或ICSI的PCOS不孕患者作回顾性分析.观察组(A组)PCOS不孕患者31例,对照组(B组)榆卵管性不孕患者287饲,对两组促性腺激素(Gn)使用的时间和荆量、HCG使用当日E2水平、获卵数、受精率、胚胎数以及临床妊娠率、流产率和卵巢过度刺激综合征(OHSS)的发生率作比较.[结果]观察组Gn使用时间和用药剂量、HCG日E2水平、获卵数、胚胎数,受精率、妊娠率与对照组差异均无显著性,观察组中流产率较高,而OHSS发生率较低.[结论]IVF-ET是PCOS不孕患者的一种有效治疗方法,但流产率较输卵管性不孕高,OHSS的发生经过积极预防处理后能得到有效控制.     

GnRH拮抗剂对体外受精-胚胎移植中多囊卵巢综合征患者有效性的系统评价

目的系统评价GnRH拮抗剂用于多囊卵巢综合征(PCOS)患者体外受精-胚胎移植的有效性。方法计算机检索PubMed(1997～2010)、ProQust Medical Library(1997～2010)、外文生物医学期刊文献数据库(2000～2010)、CBM(1979～2010)、CNKI(1994～2010)、VIP(1989～2010)、万方数据库(1994～2010)和读秀学术搜索引擎,并手工检索相关中文杂志9种,查找比较GnRH拮抗剂与GnRH激动剂在体外受精-胚胎移植PCOS患者治疗中有效性的随机对照试验(RCT)。由两位研究者按纳入排除标准筛选文献、提取资料和评价质量后,采用RevmMan 4.2.7软件进行Meta分析。结果共纳入6篇RCT,合计699例患者。其纳入研究质量A级3篇,B级3篇。Meta分析结果显示:与GnRH激动剂组比较,GnRH拮抗剂组在刺激天数[WMD=–1.23(–2.76,–0.31)]、Gn量[WMD=–4.87(–14.20,4.46)]、HCG日E2值[WMD=31.37(–263.40,–326)]、获卵数[WMD=1.34(–1.02,4.70)]、临床妊娠率[OR=1.27(0.77,2.10)]和流产率[Peto OR=0.67(0.38,1.18)]方面,两组差异均无统计学意义;仅GnRH拮抗剂组的OHSS率较低,两组差异有统计学意义[Peto OR=0.35(0.24,0.50)]。结论 GnRH拮抗剂方案较之GnRH激动剂方案能减低OHSS发生,而在Gn量、获卵数、临床妊娠率方面,两种方案疗效相当。由于GnRH拮抗剂方案可缩短治疗时间,减少治疗费用,具有较好的安全性,对PCOS患者行体外受精-胚胎移植可能是较理想的选择。鉴于纳入研究存在质量和数量的不足以及方法学的差异,上述结论仅供临床参考,需要开展更多后效评价和不断更新。     

Administration of Luteinizing Hormone Releasing Hormone Agonist for Synchronization of Estrus and Generation of Pseudopregnancy for Embryo Transfer in Rats

In the past decade, the use of genetically engineered rats has increased exponentially; therefore, the ability to perform embryo transfer (ET) in rats to rederive, reanimate, or create mutant rat lines is increasingly important. However, the successful generation of pseudopregnant female rats for ET represents a limiting factor. We here evaluated the subcutaneous administration of 40 µg luteinizing hormone releasing hormone agonist (LHRHa) for estrus synchronization during the development and implementation of a rat ET program. Our first experiment assessed endogenous estrus cycling patterns by examining vaginal cytology without administration of LHRHa in 5-wk-old peripubertal Sprague–Dawley female rats. These rats then received LHRHa at approximately 7 wk of age; 57% of the rats were synchronized in proestrus or estrus as assessed by vaginal cytology 96 h later. In a second experiment, 8-wk-old virgin, unmanipulated Sprague–Dawley female rats received LHRHa; 55% were synchronized in proestrus or estrus 96 h later. Copulatory plugs were confirmed in 28% and 82% of the rats that had been synchronized in the first and second experiments, respectively, and mated with vasectomized male rats. Embryo transfer surgery was performed, and live pups were born from both fresh and cryopreserved transgenic rat embryos. Our results indicate that subcutaneous administration of 40 µg LHRHa followed by examination of vaginal cytology 96 h later is an effective technique to generate multiple pseudopregnant recipient rats for use in an ET program.Abbreviation: ET, embryo transfer; GER, genetically engineered rat; LHRHa, luteinizing hormone releasing hormone agonistThe generation of transgenic rats is a relatively recent event, with the first successful genetically engineered rat (GER) produced in the early 1990s.^8,20 However, the technology only recently has advanced sufficiently to predictably generate GER.^7,18 The difficulty in producing GER has been due, in part, to attempts to directly extrapolate procedures, including stem cell and embryo culture, from in vivo mouse techniques.^14,22,29Assisted reproductive technologies often involve the manipulation of the estrous cycle and are performed frequently in rodent transgenic core facilities. The use of embryo transfer (ET) plays a crucial role in generating genetically modified animals and improving rodent colony health status.^6,30 ET entails the surgical transplantation of embryos into a pseudopregnant recipient. To maximize the efficiency of personnel and minimize animal numbers, transgenic core facilities routinely generate multiple pseudopregnant recipients at the same postcoital stage. Numerous methods to generate pseudopregnant recipients have been published for both mice and rats and range from mating male rodents with female rodents in spontaneous estrus to evaluating the electrical impedance of the vagina to select candidates for mating.^11,24,28 In rats, increased electrical resistance in the vagina has been shown to correlate with the estrus phase.¹¹ However, other authors have concluded that there is poor correlation between the hormonal cycle and vaginal impedance readings; therefore the use of electrical impedance in rats that have not been evaluated by vaginal cytology is suboptimal.²⁸Examination of vaginal cytology has been used in dogs, ferrets, and mice and is considered the ‘gold standard’ to accurately evaluate the phase of the estrous cycle.^23,28,334 Vaginal cytology first was used to characterize the estrous cycle of rats in 1922, and this technique has continued to be applied during the past century.^9,15,17,19 Similar to other species, rats have predominant cell types that correlate with specific phases of the estrous cycle, which lasts approximately 4 to 5 d. Proestrus in rats lasts approximately 12 h and is characterized by a predominance of nucleated epithelial cells.¹⁴ Estrus, with a duration of 9 to 15 h, is considered the receptive phase and is characterized by anucleated, cornified epithelial cells.^15,17 Early diestrus (also referred to as metestrus) has a duration of approximately 14 to 18 h and is characterized by a mixed cell population consisting of cornified and nucleated epithelial cells in the presence of leukocytes. Late diestrus has a duration of 60 to 70 h in rats and is characterized by the predominance of leukocytes.^15-17Estrus synchronization with exogenous hormones has been used for decades in the food animal industry to maximize reproductive performance and production. These exogenous hormones allow the breeding of animals within a shortened, predefined interval, often streamlining and maximizing the time and effort to generate offspring. Extrapolating from estrus synchronization in other species, namely cattle, early work in estrus synchronization of rats was performed in the 1980s by using subcutaneous implants of the exogenous luteinizing hormone releasing hormone agonist (des-Gly,¹⁰ D-Ala⁶-LH-RH ethalamide; LHRHa).³¹ LHRHa is a synthetic analog of the hypothalamic neurohormone GnRH and functions at the GnRH receptor, causing the release of FSH and LH from the anterior pituitary.⁵ By using this technique and according to vaginal cytology, 9 of 10 female albino rats (stock not specified) were in synchronized estrus 4 d after the removal of 25 µg of pelleted LHRHa that had been implanted subcutaneously for 7 d.³¹ An adaptation to this protocol using 50 µg LHRHa as a single subcutaneous injection to adult Long–Evans female rats generated copulation rates of 75% to 94% at 4 d after LHRHa administration.³² However, limitations of the cited study³¹ include the lack of evaluation of the phase of the estrous cycle before mating and the mating of female rats to intact male rats.More recently, an alternative method for estrus synchronization by using LHRHa and vasectomized male rats has been described.⁴ In the cited study,⁴ 94% of Sprague–Dawley female rats were in early estrus or estrus at 4 d after subcutaneous administration of 40 µg LHRHa, and 75% of female rats selected for mating had copulatory plugs.⁴ Because of this high rate of female rats in estrus, the authors concluded that cytologic staging of the estrous cycle of rats that had received LHRHa 4 d earlier was unnecessary.^1,4 Despite our attempts to follow this previously described protocol using 40 µg LHRHa to synchronize estrus in Sprague–Dawley female rats, we experienced much lower rates of females in estrus and could not recapitulate the authors’ results. Although numerous environmental, genetic and intrinsic species factors might have led to the differences between our findings and those of the previous study,⁴ we decided to pursue an evaluation of the natural estrous cycle of Sprague–Dawley rats by using vaginal cytology and to evaluate the effects of LHRHa on estrus synchronization, to the end of generating pseudopregnant recipients for use in an ET program.     

The Response of Thyrotropin and Triiodothyronine to Various Doses of Thyrotropin Releasing Hormone in Normal Man

Abstract. The relationship between serum thyrotropin (TSH) and serum triiodothyronine (T3) before and after injection of different doses of thyrotropin releasing hormone (TRH), given as single injections or as multiple injections with short intervals, was investigated in normal men. A positive correlation between prestimulated serum TSH and serum T₃ levels and between the increase in the serum TSH and the serum T3 levels after TRH was found when repeated tests were performed in the same individual. There was a dose dependent TSH and T3 response to TRH. The smallest dose that produced a maximal response of both TSH and T3 was only 30 ug TRH. After six injections of 30 ug TRH with an interval of 30 minutes the increase in TSH was two times and the increase in T3 was three times as high as the maximal increase after single injections of TRH. This test with multiple injections of TRH may prove to be of clinical value in the measurement of both pituitary and thyroid function in selected patients. The close positive correlation between the serum TSH and serum T3 levels in basal conditions, demonstrated in four normal subjects in this study, probably reflects the steady state level determined by the hypothalamus from which the feedback control of TSH secretion operates.     

The Response of Thyrotropin and Triiodothyronine to Various Doses of Thyrotropin Releasing Hormone in Normal Man

Abstract. The relationship between serum thyrotropin (TSH) and serum triiodothyronine (T₃) before and after injection of different doses of thyrotropin releasing hormone (TRH), given as single injections or as multiple injections with short intervals, was investigated in normal men. A positive correlation between prestimulated serum TSH and serum T₃ levels and between the increase in the serum TSH and the serum T₃ levels after TRH was found when repeated tests were performed in the same individual. There was a dose dependent TSH and T₃ response to TRH. The smallest dose that produced a maximal response of both TSH and T₃ was only 30 μg TRH. After six injections of 30 μg TRH with an interval of 30 minutes the increase in TSH was two times and the increase in T₃ was three times as high as the maximal increase after single injections of TRH. This test with multiple injections of TRH may prove to be of clinical value in the measurement of both pituitary and thyroid function in selected patients. The close positive correlation between the serum TSH and serum T₃ levels in basal conditions, demonstrated in four normal subjects in this study, probably reflects the steady state level determined by the hypothalamus from which the feedback control of TSH secretion operates.     

血清HCG、P检测对IVF-ET后妊娠结果的预测价值

目的　探讨血清HCG、P检测在IVF ET中作为妊娠结果的预测价值。方法　回顾分析 14 3例采用体外授精 胚胎移植 (IVF ET)周期患者的妊娠结果与ET后第 14天的血清HCG、P水平。结果　临床妊娠组HCG、P水平均显著高于生化妊娠组和未妊娠组 (P <0 0 1)。生化妊娠组HCG显著高于未妊娠组 (P <0 0 1) ,而P则与未妊娠组无明显差异 (P >0 0 5 )。持续妊娠组HCG、P水平显著高于流产组 (P <0 0 1)。多胎组HCG水平显著高于单胎组 (P <0 0 1) ,而P则与单胎组无明显差异 (P >0 0 5 )。以HCG≥ 10 0IU L且P≥ 2 0 μg L作为临床妊娠的预测标准 ,阳性预期值为10 0 % ,阴性预期值为 91 34% ,敏感性为 81 2 5 % ,特异性为 10 0 % ;以HCG >5 0 0IU L作为多胎妊娠的预测标准 ,阳性预期值为 6 6 6 7% ,阴性预期值为 76 19% ,敏感性为 6 6 6 7% ,特异性为 76 19%。结论　在IVF ET周期中ET后第 14天血清HCG、P在预测妊娠结果方面具有重要临床价值     

揿针在体外受精-胚胎移植经阴道超声穿刺取卵术中镇痛的应用

目的 观察揿针耳穴贴压在体外受精-胚胎移植(IVF-ET)经阴道超声穿刺取卵术中的镇痛效果及不良反应,探讨其可能的镇痛机理.方法 将2020年1月至2021年2月收治的210例行IVF-ET经阴道超声穿刺取卵术的患者按治疗方法分为3组:揿针组、耳穴压豆组、药物对照组,每组70例.揿针组和耳穴压豆组选穴均为双侧子宫、盆腔...