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目的分析体外受精-胚胎移植(in virto fertilization-embryo transfer,IVF-ET)促排卵过程中,人体绒膜促性腺激素(HCG)注射日孕酮(P)水平升高或降低对妊娠结局的影响。方法回顾分析洛阳市妇女儿童医疗保健中心在2012年4月—2016年7月行IVF-ET助孕的870个新鲜周期,根据患者HCG日P水平分为3组:A组:P<1.0 ng/ml;B组:1.0 ng/ml≤P≤1.5 ng/ml;C组:P≥1.5 ng/ml,比较3组促排卵及妊娠结局。结果比较HCG日3组受试者临床资料,3组受试者年龄、Gn天数、促黄体生成素(LH)等比较均无统计学意义(P>0.05),A组雌激素(E_2)水平较B、C两组显著降低(P<0.05),B、C两组无统计学意义(P>0.05),且卵泡经线明显低于B、C两组,差异有统计学意义(P<0.05);比较3组妊娠结局,移植率、临床妊娠率从高到低依次是A、B、C组,异位妊娠率由高到低依次是C、A、B组,组间差异有统计学意义(P<0.05)。结论 IVF-ET控制性超排卵中,HCG每日注射量孕酮水平升高对胚胎质量无显著影响,但HCG日P水平升高对妊娠率、移植成功率均有一定的影响。
OBJECTIVE: To analyze the effect of increasing or decreasing progesterone (P) levels on the outcome of pregnancy during human ovulation induction by in vitro fertilization-embryo transfer (IVF-ET) . Methods The 870 fresh cycles of IVF-ET assisted pregnancy in Luoyang Women’s and Children’s Medical Center from April 2012 to July 2016 were retrospectively analyzed. Group A: P <1.0 ng / ml; Group B: 1.0 ng / ml≤P≤1.5 ng / ml; Group C: P≥1.5 ng / ml, and compared three groups of ovulation induction and pregnancy outcomes. Results There was no significant difference in age, Gn days, luteinizing hormone (LH) between the three groups of subjects (P> 0.05), the level of estrogen (E2) in group A (P <0.05). There was no significant difference between B and C groups (P> 0.05), and the warp of follicles was significantly lower than that of B and C groups (P <0.05) ). The pregnancy outcomes, the rate of transplantation and the clinical pregnancy rate of the three groups were A, B and C in descending order, and the rates of ectopic pregnancy were C, A and B in turn from high to low, the differences among the groups were statistically significant Significance (P <0.05). Conclusion In IVF-ET controlled ovarian hyperstimulation, the daily injection of HCG increased the progesterone level without any significant effect on the embryo quality. However, the increase of P level on the HCG day had some effects on the pregnancy rate and the success rate of transplantation.