在卵巢刺激监测期间意外的雌激素下降会影响累积活产
Haixiao Chen1, Kezhen Huang1, Caihui Ma1
1Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian, China.
Frontiers in endocrinology
|November 5, 2025
概括
卵巢刺激期间血清雌激素 (E2) 降低预测受控卵巢刺激 (COS) 的妇女的累积活产率 (CLBRs) 较低. 这种E2下降主要影响胚胎产量,突显了它作为预测COS结果的生物标志物的持续重要性.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精 (IVF)
- 临床产科和妇科 临床产科和妇科
背景情况:
- 雌激醇 (E2) 在刺激周期期间对卵泡发育至关重要.
- 升的E2水平通常与毛囊生长至成熟相关.
- 在受控卵巢刺激 (COS) 监测期间意外的E2下降的临床意义受到争议.
研究的目的:
- 调查COS监测期间E2下降与累积活产率 (CLBRs) 之间的关联.
- 分析E2下降对新生胚胎移植后卵细胞产量,胚胎产量和活产率的影响.
- 探索潜在的调解因素和子组变化影响E2下降和COS结果之间的关系.
主要方法:
- 追溯分析了27,487个传统的COS周期.
- 关于E2下降的定义:与之前的诊所相比,血清E2值较低.
- 使用倾向匹配和多变量通用线性模型进行统计分析,以评估与CLBRs的关联.
主要成果:
- 在10.3%的患者中观察到E2的下降,在不匹配和匹配的队列中显著降低了CLBRs.
- E2的下降与卵细胞和胚胎产量减少有关;然而,新鲜转移后的活产在匹配后没有显著影响.
- 调解分析表明,胚胎产量下降是降低CLBRs的主要驱动因素. 连续两次E2下降的患者表现明显较差.
结论:
- 在COS监测期间的E2下降是降低CLBRs的重要预测因素,加强其作为关键生物标志物的作用.
- 在E2下降和CLBRs之间的总体关联是温和的,需要注意特定的患者子组.
- 连续的E2下降代表了一个潜在的更糟糕结果的子组,需要更密切的监测和个性化治疗策略.
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