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目的:探讨晚卵泡期血清孕酮升高对卵裂期胚胎移植临床妊娠结局的影响。方法:选取2011年2月~2012年2月在吉林市妇产医院行常规体外受精-卵裂期胚胎移植(IVF-ET)共2 434个周期。根据实际注射h CG日血清孕酮水平分为孕酮正常组(2 156个周期)和孕酮升高组(278个周期)。对比两组的临床妊娠结局。结果:两组研究对象的平均年龄、不孕类型和年限、体重指数(BMI)、输卵管情况、促性腺激素天数、子宫内膜厚度及移植胚胎数比较差异均无统计学意义(P>0.05);孕酮正常组促性腺激素用量明显低于孕酮升高组,差异有统计学意义(P<0.05)。孕酮升高组注射h CG日雌二醇及孕酮水平、获卵数及异位妊娠率明显高于孕酮正常组,受精率及临床妊娠率明显低于孕酮正常组,差异均有统计学意义(P<0.05)。结论:晚卵泡期血清孕酮水平升高会降低卵裂期胚胎移植的临床妊娠率,增加异位妊娠的发生风险。
Objective: To investigate the effect of serum progesterone in late follicular phase on clinical pregnancy outcome in cleavage stage embryo transfer. Methods: A total of 2 434 cycles of routine in vitro fertilization-cleavage embryo transfer (IVF-ET) in Jilin Maternity Hospital from February 2011 to February 2012 were selected. Serum progesterone levels were divided into normal progesterone group (2 156 cycles) and progesterone elevated group (278 cycles) according to the actual injection of h CG serum progesterone. The clinical pregnancy outcomes were compared between the two groups. Results: There were no significant differences in mean age, type and length of infertility, body mass index (BMI), fallopian tube, days of gonadotrophin, endometrial thickness and number of embryos transferred between the two groups (P> 0.05) ; The dosage of gonadotropin in normal progesterone group was significantly lower than that of progesterone group (P <0.05). The level of estradiol and progesterone in hCG and the number of oocytes retrieved and the rate of ectopic pregnancy were significantly higher in the progesterone group than those in the normal progesterone group. The fertilization rate and clinical pregnancy rate were significantly lower than those in the normal progesterone group Statistical significance (P <0.05). CONCLUSION: Elevated serum progesterone level in late follicle phase reduces the clinical pregnancy rate during cleavage stage embryo transfer and increases the risk of ectopic pregnancy.