IVF—ET周期中黄体期雌激素水平变化与妊娠关系的临床研究

目的：探讨体外受精-胚胎移植（IVF—ET）周期中黄体期雌激素变化与临床妊娠的关系，从而分析黄体期补充雌激素的必要性。方法：92个超排卵IVF／gg细胞浆单精子注射（ICSI）-ET周期按妊娠结局分为妊娠组和未妊娠组，两组患者均在取卵后常规单纯注射黄体酮60mg，在卵泡成熟日，即人绒毛膜促性腺激素（hCG）日及取卵后第7、10、13天（d7、d10、d13）测定血清雌二醇（E：）水平。①比较妊娠组和未妊娠组hOG日、d7、d10、d13E2水平及d7、d10、d13E2水平与hOG日E2水平的比值E2（dn）／E2（hCG日）]。②分别以E2（d7）／E2（hOG日）、E2（d10）／E2（hCG日）、E2（d13）／E2（hOG日）值的25％、50％和75％为界点将所有患者分为A组（〈25％）、B组（25％-50％）、c组（〉50％～75％）、D组（〉75％）组，比较各组妊娠率。结果：①仅取卵后d13E2水平及E2（d13）／E2（hOG日）值妊娠组与未妊娠组差异有统计学意义（Z=-6．229，P〈0．01；Z=-3．426，P〈O．01）；②以E2（dn）／E2（hOG日）值的分组比较，仅d13的4组差异有统计学意义（P〈0．05）。结论：在使用超排卵的IVF／ICSI—ET周期中，黄体期雌激素的变化并不影响临床妊娠率，因而可不补充雌激素。

Correlation between estrogen changes in luteal phase and pregnancy outcome in IVF -ET cycles

Objective ： To explore the correlation between estrogen changes in luteal phase and pregnancy outcome in IVF - ET cycles, and to further explore that the necessary of additional estradiol supplementation in luteal phase. Methods ： A total of 92 IVF - ET cycles were divided into the pregnant group and the non - pregnant group. Women in two groups had the same con- trolled ovarian stimulation （COH） regimen and only using progesterone for corpus luteum support. Estrogen levels of two groups on the day - of - hCG and the 7th （ d7 ）, 10th （ dl0 ）, 13th （ d13 ） day after the egg retrieval were evaluated. And women were divided into A （ 〈25% ）, B （25% to 50% ）, C （ 〉50% to 75% ） and D （ 〉75% ） groups according to the ratios of estradiol on the day - of - hCG and d7/d10/d13. Results： Only on the d13, there were significant differences in the estrogen level and the ratio of estradiol on the day - of - hCG and d13 between the two groups （Z = -6. 229, P 〈0. 001 ; Z = -3. 426 ,P 〈 O. 001 ）. Only the clinical pregnancy rates of d13 were significantly different among group A, B, C, D （P 〈 0.05 ）. Conclusion ： Presumably the successful implantation of embryos affects estrogen changes, rather than estrogen changes affect pregnant outcomes.