自然月经周期重新审视 - - 自然周期可信吗?
B Alsbjerg1,2, U S Kesmodel3,4, P Humaidan5,6
1The Fertility Clinic, Skive Regional Hospital, Resenvej 25, Skive, Denmark. alsbjerg@dadlnet.dk.
Journal of ovarian research
|July 22, 2024
概括
在健康的女性中,黄体阶段的孕水平往往低于怀孕的最佳水平,显示出显著的变化. 升高的卵泡阶段雌激素 (E2) 可以预测足够的孕激素,表明黄体体能力.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 人体生理学 人体生理学
背景情况:
- 血清孕激素 (P4) 对于怀孕的开始和维持至关重要.
- 自然周期P4水平对于植入和早期怀孕的足够性是有争议的,特别是随着自然周期冷胚胎移植的使用越来越多.
- 使用卵泡阶段激素水平和共变量预测质阶段P4水平是有趣的.
研究的目的:
- 为了研究血清孕激素 (P4) 水平在健康妇女的黄质期 (LP) 期间的变化.
- 为了确定卵泡期 (FP) 激素水平和其他共变量是否可以预测LP P4水平.
主要方法:
- 观察性前性队列研究,对26名正常月经周期和BMI<30 kg/m2的健康女性进行了观察.
- 每五天抽取血液样本,进行三次循环,从循环第5天开始.
- 对血清P4,雌激素 (E2),卵泡刺激激素 (FSH),化激素 (LH),抗穆勒尔激素 (AMH) 和腹卵泡计数 (AFC) 的分析.
主要成果:
- 在26名女性中,只有10名女性在三个周期中始终达到P4水平>30nmol/L.
- 在77个周期中,有45个周期的P4水平≥30nmol/L.
- 周期第10天E2水平≥345 pmol/L预测LP P4≥30 nmol/L,灵敏度为57%和特异性为89%.
- 在FPFSH,LH,年龄,体重,AFC或AMH和LP P4水平之间没有发现显著的相关性.
结论:
- 周期第5天 (> 131 pmol/L) 和周期第10天 (> 345 pmol/L) 的毛囊期E2水平是足够的黄质期P4水平 (≥ 30 nmol/L) 的显著预测指标.
- FP E2水平可以作为红色体能力的预测指标.
- 低于最佳的P4水平和LP P4的显著个体间/周期内变化甚至存在于周期常规的女性中.
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