促黄体生成素水平对卵巢储备功能正常不孕症患者体外受精-胚胎移植结局的影响OA
Effect of luteinising hormone levels on the outcome of in vitro fertilization and embryo transfer in an infertile population with normal ovarian reserve
目的 探讨拮抗剂方案控制下超促排卵(COH)过程中,不同时间点促黄体生成素(LH)水平对卵巢储备功能正常(NOR)不孕症患者体外受精-胚胎移植(IVF-ET)结局的影响,并初步分析卵泡期LH的理想水平区间.方法 回顾性分析911例采用拮抗剂方案治疗IVF-ET的NOR不孕症患者.根据基础LH(bLH)水平、拮抗剂添加日LH水平以及人绒毛膜促性腺激素(hCG)注射日LH水平进行分组,根据bLH水平将患者分为A2组(n=391)和B2组(n=391),根据拮抗剂添加日LH水平将患者分为A3组(n=600)和B3组(n=311),根据hCG注射日LH水平将患者分为A4组(n=225)、B4组(n=227)、C4组(n=231)和D4组(n=228),比较各组患者的临床特征、COH结局以及妊娠结局.结果 ① bLH水平可作为NOR不孕症患者助孕结局的预测指标,当bLH≥4.51 IU/L时,可获得更优的妊娠结局;② 促排卵过程中,LH≥5 IU/L时添加拮抗剂,可能有利于改善妊娠结局;③ 根据hCG注射日LH水平分组,各组患者间的妊娠结局差异均无统计学意义;④ 广义线性模型分析显示,基础促卵泡激素(bFSH)、基础雌二醇(bE2)、促性腺激素(Gn)天数、Gn量以及双原核(2PN)数,与优质胚胎数相关.结论 对于采用拮抗剂方案的NOR不孕症患者,bLH和拮抗剂添加日LH水平可能影响IVF-ET结局,bLH≥4.51 IU/L时进行辅助生殖可能有助于改善妊娠结局;促排卵过程中,LH≥5 IU/L时添加拮抗剂效果更好.
Objective To investigate the effects of luteinizing hormone(LH)levels on in vitro fertilization and em-bryo transfer(IVF-ET)outcomes in an infertile population with normal ovarian reserve(NOR)undergoing con-trolled ovarian hyperstimulation(COH)with gonadotropin-releasing hormone antagonist protocol,and to explore the reasonable level intervals of LH during the follicular phase.Methods A retrospective analysis was conducted on 911 NOR infertility patients undergoing IVF-ET treated with gonadotropin-releasing hormone antagonist proto-col.Patients were grouped based on baseline LH(bLH)levels,LH levels on the day of antagonist addition,and LH levels on the day of human chorionic gonadotropin(hCG)injection.According to bLH levels,patients were di-vided into Group A2(n=391)and Group B2(n=391).Based on LH levels on the day of antagonist addition,pa-tients were divided into Group A3(n=600)and Group B3(n=311).According to LH levels on the day of hCG in-jection,patients were classified into Group A4(n=225),Group B4(n=227),Group C4(n=231),and Group D4(n=228).The clinical characteristics,COH outcomes,and pregnancy outcomes of patients in each group were compared.Results ① The bLH level could be used as a predictor of assisted reproduction outcomes in an infertile population with NOR,and going for assisted reproduction at bLH≥4.51 IU/L was more favorable for the develop-ment of pregnancy outcomes;② Addition of antagonist at LH≥5 IU/L on the day of antagonist addition improved pregnancy outcome;③ On the day of hCG injection,there was no statistically significant difference in pregnancy outcomes among the four groups;④ Analyses using generalized linear models revealed that basal follicle-stimulating hormone(bFSH),basal estradiol(bE2),Gn days,Gn volume and 2PN affected the number of good quality embryos.Conclusion In an infertile population with NOR using gonadotropin-releasing hormone antago-nist,bLH and gonadotropin-releasing hormone antagonist addition day LH levels may influence IVF outcomes.LH levels should be controlled at 5 IU/L and above on antagonist addition days,and bLH levels should be controlled at 4.51 IU/L and above.
郑琦;苏荀;杨静;纪冬梅
安徽医科大学第一附属医院妇产科,合肥 230022安徽医科大学第一附属医院妇产科,合肥 230022安徽医科大学第一附属医院妇产科,合肥 230022安徽医科大学第一附属医院妇产科,合肥 230022||国家卫生健康委配子及生殖道异常研究重点实验室,合肥 230022
医药卫生
拮抗剂方案促黄体生成素体外受精-胚胎移植卵巢储备功能正常人群不孕症妊娠结局
gonadotropin-releasing hormone antagonist protocolluteinizing hormonein vitro fertilization and embryo transfernormal ovarian reserve populationinfertilitypregnancy outcome
《安徽医科大学学报》 2026 (5)
888-893,6
安徽省高等学校科研计划项目(编号:2022AH020072) Natural Science Research Project of Anhui Educational Committee(No.2022AH020072)
评论