控制性超促排卵中人绒毛膜促性腺激素最佳扳机时间的探讨

本文综合分析了hCG注射日LH、E2、P、E2/P水平,及hCG注射日卵泡大小、每卵泡血清E2水平等各因素与hCG注射时机的相互关系,并指出hCG扳机时机需在卵泡大小达到一定程度,大卵泡达到一定比例,每卵泡E2水平达到200~350 pg/ml之间时,兼顾各激素水平及内膜情况进行综合考虑。

Best Time of Human Chorionic Gonadotropin to Trigger Ovulation in Controlled Ovarian Hyperstimulation

There were two important elements in in vitro fertilization and embryo transplantation(IVF-ET).One is to obtain a synchronous mature egg of high quality which can develop into a plantation potencial embryo after fertilization;the other is a synchronous developped endometrium which allows the embryo implantation.And how to choose the appropriate hCG time to trigger ovulation is crucial to affect above two factors.hCG can stimulate the luteinizing hormone(LH) surge,which has the effect on evoke follicle maturation,ovulation,and corpus luteum funcion.Therefore,hCG injection has become a indispensable part in controlled ovarian hyperstimulation(COH).If the injection of hCG is too earlier,the cumulus cells are too small and attach follicle wall tightly,which will influence the oocyte recovery,and most of collected oocytes may be immatured which will result in low fertilization rate.If hCG injection is too late,endogenous LH surge will occur and make early recovery of oocytes mitosis,so that the oocytes will miss the best time of fertilization,cleavage and implantation after oocyte retrival.Now the studies focus on the best time of hCG injection,and there are no uniform standards in the whole world.Our study reviewed papers of hCG injection and summarize the related factors.