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目的:探讨人绒毛膜促性腺激素注射日(HCG日)每卵泡血清雌激素水平及孕酮/雌激素(P/E2)比值对体外受精-胚胎移植(IVF-ET)助孕结局的预测价值。方法:接受常规IVF-ET助孕的不孕症患者236例,按照HCG日每卵泡血清E2水平分为5组:A组10例(E2<513pmol/L),B组81例(513pmol/L≤E2≤1 026pmol/L),C组86例(1 027pmol/L≤E2≤1 540pmol/L),D组47例(1 541pmol/L≤E2≤2 055pmol/L),E组12例(E2>2 055pmol/L);按照HCG日P/E2比值分为3组:A’组114例(P/E2<0.35),B’组96例(0.35≤P/E2≤0.70),C’组26例(P/E2>0.70)。回顾性分析IVF助孕结局。结果:HCG日每卵泡血清E2水平<513pmol/L及E2>2 055pmol/L时受精率(70.87%,70.07%)最低。HCG日每卵泡血清E2水平<513pmol/L时妊娠率(30.00%)最低。HCG日血清P/E2比值>0.7时妊娠率最低。结论:在控制性促排卵过程中,HCG日每卵泡血清E2水平结合P/E2比值是促排卵过程中扳机时机的重要参考指标,合适的雌孕激素水平是影响IVF助孕结局的重要因素。
OBJECTIVE: To investigate the predictive value of serum progesterone level and progesterone / estrogen (P / E2) ratio on the outcome of in vitro fertilization-embryo transfer (IVF-ET) on human chorionic gonadotropin injection (HCG) . Methods: A total of 236 infertility patients receiving IVF-ET assisted pregnancy were divided into 5 groups according to E2 level on HCG day: 10 cases in group A (E2 <513 pmol / L), 81 cases in group B (513 pmol / L ≤ E2 ≤ 1026 pmol / L), 86 patients in group C (1027 pmol / L≤E2≤1 540 pmol / L), 47 patients in group D (541 pmol / L≤E2≤2 055 pmol / L) and 12 patients in group E E2> 2 055pmol / L). According to the P / E2 ratio on HCG day, the patients were divided into three groups: 114 in the A ’group (P / E2 <0.35), 96 in the B’ group (0.35≤P / E2≤0.70) Group of 26 patients (P / E2> 0.70). Retrospective analysis of IVF pregnancy outcomes. Results: The serum E2 level of every follicle on HCG day was the lowest (<703%, 70.07%) with <513 pmol / L E2 and E2> 0.055 pmol / L. HCG daily follicular serum E2 level <513pmol / L when the pregnancy rate (30.00%) lowest. HCG day serum P / E2 ratio> 0.7 when the lowest pregnancy rate. CONCLUSION: During the process of controlled ovulation induction, the serum E2 level and P / E2 ratio of every follicle on HCG day is an important reference index for the timing of triggering ovulation induction. Proper estrogen and progesterone levels are important factors that influence IVF assisted pregnancy outcome.