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目的探讨在体外受精与胚胎移植(IVF-ET)中,注射人绒毛膜促性腺激素(HCG)日血清催乳素(PRL)浓度对妊娠的影响。方法回顾性分析2005年10月至2008年3月期间127个体外受精与胚胎移植周期的资料。结果在控制性卵巢刺激(COS)中,按注射HCG日血清催乳素浓度不同分4组,依次为<30ng/mL(A组),≥30～<60ng/mL(B组),≥60～<90ng/mL(C组),≥90ng/mL(D组)。体外受精与胚胎移植的种植率分别为13.68%、24.16%、15.90%、2.86%;临床妊娠率分别为25.00%、47.17%、29.41%、7.69%。各组的种植率及临床妊娠率差异有统计学意义(χ2检验,P值分别为0.018和0.019)。进一步进行两两比较,HCG日PRL≥90ng/mL(D组)的种植率及妊娠率明显较PRL水平≥30～<60ng/mL(B组)低,差异有统计学意义(P值分别为0.005和0.009)。结论控制性卵巢刺激后血清催乳素浓度较基础水平明显升高,导致暂时性高催乳素血症。当HCG注射日血清催乳素明显升高(≥90ng/mL)时,体外受精与胚胎移植的种植率及临床妊娠率明显下降。对控制性卵巢刺激过程中催乳素水平异常的患者给予严密的监测和适当的干预,有助于提高临床妊娠率。
Objective To investigate the effect of human serum prolactin (PRL) on human pregnancy induced by human chorionic gonadotropin (HCG) during in vitro fertilization and embryo transfer (IVF-ET). Methods The data of 127 in vitro fertilization and embryo transfer cycles from October 2005 to March 2008 were retrospectively analyzed. Results In control ovary stimulation (COS), the concentrations of serum prolactin on the day of HCG injection were divided into 4 groups according to the following schedule: <30ng / mL (group A), ≥30 ~ <60ng / mL (group B) <90 ng / mL (group C),> 90 ng / mL (group D). The implantation rates of in vitro fertilization and embryo transfer were 13.68%, 24.16%, 15.90% and 2.86% respectively; the clinical pregnancy rates were 25.00%, 47.17%, 29.41% and 7.69% respectively. The differences in implantation rate and clinical pregnancy rate between the two groups were statistically significant (χ2 test, P = 0.018 and 0.019, respectively). For further comparison, the implantation rate and pregnancy rate of PRL≥90ng / mL (group D) on day HCG were significantly lower than those of PRL≥30 ~ <60ng / mL (group B), with significant difference (P = 0.005 and 0.009). Conclusion Serum prolactin concentration is significantly higher than the basic level after controlled ovarian stimulation, resulting in transient hyperprolactinemia. When serum prolactin was significantly elevated (≥90ng / mL) on HCG injection, the implantation rate and clinical pregnancy rate of in vitro fertilization and embryo transfer decreased significantly. Patients with abnormal prolactin levels during controlled ovarian stimulation should be given close monitoring and appropriate interventions to help improve clinical pregnancy rates.