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目的探讨在控制性超排卵(COH)中体外受精-胚胎移植(IVF-ET)不同卵巢反应患者hCG注射日孕酮水平对妊娠结局的影响。方法回顾性分析行IVF-ET的1077例患者的资料,根据获卵数将卵巢反应分为高反应组、正常反应组和低反应组。均采用黄体期长方案控制性促排卵。化学发光法检测hCG日孕酮(P)水平。根据P水平分组:<3.18 nmol/L、3.18~3.98 nmol/L、3.99~4.77 nmol/L、4.78~5.57 nmol/L、5.58~6.36 nmol/L、>6.36 nmol/L。分别比较不同反应组新鲜周期的妊娠率、获卵数、优胚数及妊娠结局。结果 1高反应组及正常反应组>6.36 nmol/L患者临床妊娠率最低(18.75%,3/16;12.50%,2/16),低反应组P>4.77 nmol/L患者临床妊娠率低(9.09%,1/11);2高反应组及正常反应组P≤6.36 nmol/L组临床妊娠率(44.88%,114/238;42.19%,278/659)较>6.36 nmol/L组高(18.75%,3/16;12.5%,2/16;P<0.05);3低反应组P≤4.77 nmol/L组临床妊娠率较>4.77 nmol/L组高(41.35%,55/133;6.67%,3/16;P<0.05)。各组获卵数和优胚数比较,差异均无统计学意义(P>0.05)。结论 hCG日血清P水平明显升高可影响IVF-ET的妊娠率。卵巢不同反应者其P升高影响妊娠率的切点值不同。
Objective To investigate the effect of progesterone on the outcome of pregnancy induced by hCG injection in IVF-ET patients with controlled ovarian hyperstimulation (COH). Methods The data of 1077 patients with IVF-ET were retrospectively analyzed. The ovarian response was divided into high response group, normal response group and low response group according to the number of oocytes retrieved. Both long-term control of luteal phase ovulation. Chemiluminescence method was used to detect the level of progesterone (P) on hCG day. According to the level of P group: 3.18 ~ 3.98 nmol / L, 3.99 ~ 4.77 nmol / L, 4.78 ~ 5.57 nmol / L, 5.58 ~ 6.36 nmol / L,> 6.36 nmol / L. The pregnancy rate, the number of oocytes retrieved, the number of excellent embryos and the pregnancy outcome were compared between different response groups respectively. Results The clinical pregnancy rate was the lowest (18.75%, 3/16; 12.50%, 2/16) in patients with high response and normal response> 6.36 nmol / L, and the clinical pregnancy rate was low in patients with low reaction P> 4.77 nmol / L 9.09%, 1/11) .2 The clinical pregnancy rates of high and normal reaction group (P≤6.36 nmol / L) were significantly higher than those of> 6.36 nmol / L group (44.88%, 114/238; 42.19%, 278/659) (P <0.05). The clinical pregnancy rate of P≤4.77 nmol / L group was higher than that of> 4.77 nmol / L group (41.35%, 55/133, 6.67 %, 3/16; P <0.05). There were no significant differences in the numbers of retrieved oocytes and excellent embryos in each group (P> 0.05). Conclusions Serum P level of hCG significantly increased the pregnancy rate of IVF-ET. Ovarian response to different factors in the impact of pregnancy on the rise in the cut-point value of different points.