摘要
目的探讨长方案体外受精-胚胎移植(IVF-ET)中应用重组人绒毛膜促性腺激素(HCG)诱发排卵次日血清β-HCG水平与临床结局的关系。方法回顾性分析行IVF-ET长方案治疗的907例患者的临床资料,均应用注射用重组HCG诱导排卵,根据诱导排卵次日血清β-HCG水平分为A组(β-HCG<50 U/L)47例、B组(50 U/L≤β-HCG<80 U/L)137例、C组(80 U/L≤β-HCG<110 U/L)267例、D组(110 U/L/L≤β-HCG<140 U/L)202例、E组(β-HCG≥140 U/L)254例,比较5组的促性腺激素(Gn)类药物使用天数和剂量、HCG日血清雌二醇(E2)水平和子宫内膜厚度、获卵率、卵子成熟率、受精率、优质胚胎率、临床妊娠率、卵巢过度刺激综合征发生率、流产率。结果 A组、B组、C组、D、E组获卵率依次升高(P<0.05)。A组Gn使用量和天数、卵子成熟率、受精率高于其他组(均P<0.05)。5组HCG日E2水平、HCG日子宫内膜、第3天的可移植胚胎数、优质胚胎率、临床妊娠率和流产率比较,差异均无统计学差异(均P>0.05)。结论在长方案IVF-ET周期中,应用重组HCG诱发排卵后血清β-HCG水平可能与获卵率有关,但不影响临床妊娠率。
Objective To investigate the relationship between serum beta-human chorionic gonadotropin(β-HCG) level after induced ovulation by recombinant HCG and clinical outcome in a prolonged protocol of in vitro fertilization and embryo transfer(IVF-ET). Methods The clinical data of 907 patients treated with a prolonged protocol of IVF-ET were retrospectively analyzed. Induced ovulation by recombinant HCG was conducted in all cases. The patients were divided into group A(β-HCG < 50 U/L,n = 47),group B(50 U/L≤β-HCG < 80 U/L,n = 137),group C(80 U/L≤β-HCG < 110 U/L,n = 267),group D(110 U/L≤β-HCG < 140 U/L,n = 202) and group E(β-HCG ≥140 U/L,n = 254) according to the serum β-HCG level after induced ovulation. The use duration and consumption of gonadotropin,serum estradiol level and endometrial thickness at induced ovulation,rate of oocytes retrieval,rate of oocyte maturation,fertility rate,rate of high-quality embryo,clinical pregnancy rate,incidence rate of ovarian hyperstimulation syndrome(OHSS),and abortion rate were compared between the five groups. Results The rate of oocytes retrieval increased in the order of group A,group B,group,group D and group E(P < 0. 05). The use duration and consumption of gonadotropin,rate of oocyte maturation,and fertility rate of group A were higher than those of the other groups(P < 0. 05). There were no significant differences in the estradiol level or endometrial thickness at induced ovulation,number of transferred embryo on the 3 rd day,rate of high-quality embryo,clinical pregnancy rate or abortion rate among the five groups(all P > 0. 05).Conclusion In the prolonged protocol of IVF-ET cycle,serum β-HCG level after induced ovulation by recombinant HCG is probably related to the rate of oocytes retrieval,but does not affect the clinical pregnancy rate.
引文
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