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在排卵和胚胎转移触发之间的E2水平下降是否会影响IVF-ICSI周期的生殖结果?

Nefise Nazlı Yenigül1, Runa Özelci2, Emre Başer3

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概括

在接受辅助生殖技术 (ART) 的妇女中,hCG注射后雌激素 (E2) 水平的显著下降与较低的活产率和较高的流产率有关,特别是在高响应者中. 这种E2下降影响了ART的成功.

关键词:
在E2下降.高水平的卵巢反应.活生生的出生率是多少低的卵巢储备 低的卵巢储备流产率是流产的发生率.

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科学领域:

  • 生殖内分泌学 生殖内分泌学
  • 不孕症研究 不孕症研究
  • 辅助生殖技术 (ART) 是一种辅助生殖技术.

背景情况:

  • 在辅助生殖技术 (ART) 周期期间,血清雌激素 (E2) 水平波动.
  • 人体胆性淋巴激素 (hCG) 给药和胚胎移植 (ET) 之间的E2下降率可能会影响ART的结果.
  • 了解这些动态对于优化不育治疗至关重要.

研究的目的:

  • 评估血清雌激醇 (E2) 水平下降率对ART成功的影响.
  • 在不同的不孕症病因和卵巢反应组中研究这种效应.
  • 为了确定与植入和活产率相关的特定E2下降值.

主要方法:

  • 一组1928名年龄在20-45岁的女性接受了新的ET,并根据卵巢反应 (低,高,正常) 分类.
  • 在hCG注射和ET之间,患者根据E2水平下降 (<20%,20-40%,41-60%,>60%) 进行分组.
  • 植入率,活产率 (LBR) 和流产率 (MCR) 是主要和次要结果指标.

主要成果:

  • 在高响应者中,hCG后E2水平下降超过60%与较低的LBR和较高的MCR有关.
  • 在正常反应的女性中,≥60%的E2下降显著增加了MCR,但没有LBR.
  • 根据卵巢反应,E2下降率对ART成功产生了差异性影响.

结论:

  • 在新 ET 周期中hCG 后显著的 E2 降低 (>60%) 对高响应者的 LBR 有负面影响.
  • 对于正常响应者来说,显著的E2下降主要影响流产率.
  • 监测E2动力学对于预测和潜在地改善ART结果很重要.