拮抗剂方案助孕hCG日雌二醇水平对妊娠结局的影响

目的探讨拮抗剂方案人绒毛膜促性腺激素（hCG）日血清雌二醇（E₂）水平对新鲜胚胎移植周期妊娠结局的影响。方法回顾性分析行体外受精-胚胎移植/卵胞浆内单精子注射（IVF/ICSI）拮抗剂方案助孕共216个周期病人的临床资料。根据hCG日E₂水平将其分为4组:A组 < 1 600 pg/mL，B组1 600~3 200 pg/mL，C组>3 200~4 800 pg/mL，D组>4 800 pg/mL。比较各组获卵数、单个卵泡E₂水平、获胚胎数、受精率、卵裂率、优质胚胎率、胚胎种植率、临床妊娠率和早期流产率。结果B、C、D组获卵数、获胚胎数较A组高，C、D组较B组高，D组较C组高（P < 0.05）。C、D组单个卵泡E₂水平较A组高，D组较B组高（P < 0.05）。D组胚胎种植率较B、C组低（P < 0.05），4组受精率、卵裂率、优质胚胎率、临床妊娠率及早期流产率差异均无统计学意义（P>0.05）。结论拮抗剂方案中高E₂水平病人获卵数及获胚胎数增多，优质胚胎率不会受到影响，但鲜胚移植胚胎种植率降低。

Effect of estradiol level on pregnancy outcome on the hCG day of antagonist protocol

ObjectiveTo investigate the effect of estradiol (E₂) level on the human chorionic gonadotropin(hCG)day of antagonist protocol on the pregnancy outcome of fresh embryo transfer cycle.MethodsThe clinical data of 216 cycles of in vitro fertilization and embryo transfer/intra cytoplasmic sperm injection (IVF/ICSI) antagonist protocol were retrospectively analyzed.According to the E₂ level on hCG day, the patients were divided into group A (< 1 600 pg/mL), group B (1 600-3 200 pg/mL), group C (>3 200-4 800 pg/mL), and group D (>4 800 pg/mL).The number of obtained oocytes, E₂ level of single follicle, number of obtained embryos, fertilization rate, cleavage rate, high-quality embryo rate, embryo implantation rate, clinical pregnancy rate and early abortion rate were compared between the two groups.ResultsThe number of obtained oocytes and obtained embryos in group B, group C and group D was higher than that in group A, which in group C and group D was higher than that in group B, and which in group D was higher than that in group C(P < 0.05).The E₂ level of single follicle in group C and group D was higher than that in group A, which in group D was higher than that in group B (P < 0.05).The embryo implantation rate in group D was lower than that in group B and group C (P < 0.05).There was no statistical difference in fertilization rate, cleavage rate, high-quality embryo rate, clinical pregnancy rate and early abortion rate among the four groups (P>0.05).ConclusionsIn the antagonist protocol, the number of obtained oocytes and embryos in patients with high E₂ level increases, and the rate of high-quality embryos is not affected, but the implantation rate of fresh embryo transfer decreases.