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目的:探讨HCG日雌激素(E_2)降低对促排卵结局的影响。方法:回顾分析2010年1月至2016年4月在福建省妇幼保健院生殖中心因注射HCG日E_2上升者791例(上升组)和E_2自然下降者485例(下降组)。将E_2下降组(B组)分为三个亚组:0<△E_2≤10%,10%<△E_2≤20%,△E_2>20%。比较各组的卵子回收率、受精率、卵裂率、优质胚胎率、临床妊娠率及流产率。结果:下降组的卵子回收率、卵裂率、优质胚胎率均低于上升组(P<0.05),两组的临床妊娠率和流产率比较,差异无统计学意义。HCG日雌激素下降大于20%与低卵子回收率、低卵裂率、低优质胚胎率相关(P<0.05),但不影响临床妊娠率和流产率。结论:HCG日E_2自发下降大于20%影响控制性超排卵的结局。
Objective: To investigate the effect of decreasing estrogen (E2) on ovulation induction on HCG day. Methods: From January 2010 to April 2016, 791 cases of ascending E_2 and 485 cases of descending E_2 in the Reproductive Center of MCH in Fujian Province were retrospectively analyzed. The E_2 descending group (group B) was divided into three subgroups: 0 <△ E_2≤10%, 10% <△ E_2≤20% and △ E_2> 20%. The recovery rate, fertilization rate, cleavage rate, quality embryo rate, clinical pregnancy rate and abortion rate of each group were compared. Results: The egg recovery rate, cleavage rate and high quality embryo rate in descending group were lower than those in descending group (P <0.05). There was no significant difference in clinical pregnancy rate and abortion rate between the two groups. HCG daily estrogen decline greater than 20% and low egg recovery rate, low cleavage rate, low quality embryo rate (P <0.05), but does not affect the clinical pregnancy rate and abortion rate. Conclusion: The spontaneous decrease of E_2 on HCG day is more than 20%, which affects the outcome of controlled superovulation.