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目的:探讨在控制性卵巢刺激(COS)周期中晚卵泡期孕酮(P)水平变化趋势对体外受精-胚胎移植(IVF-ET)结局的影响。方法:回顾分析2013年1月至2014年6月在我中心行IVF-ET长方案助孕治疗的676个周期。按促排卵中晚卵泡期起始日(主导卵泡直径达13mm日)与人绒毛膜促性腺激素(HCG)注射日孕酮水平变化,分为升高趋势组和降低趋势组;按HCG日孕酮水平是否>1.0ng/ml将升高趋势组和降低趋势组中新鲜移植周期分别分为A组(P≤1ng/ml)、B组(P>1ng/ml)和C组(P≤1ng/ml)、D组(P>1ng/ml)。结果:(1)升高趋势组与降低趋势组的卵裂率、优质胚胎率比较,差异有统计学意义(99.65%vs 99.00%,70.57%vs 63.09%;P<0.05);(2)A组与B组的临床妊娠率、活产率比较,差异有统计学意义(56%vs 43.00%;50%vs 37.76%,P<0.05);C组与D组的临床妊娠率、活产率比较,差异无统计学意义(P>0.05)。结论:IVF-ET长方案周期中,COS过程中孕酮变化呈升高趋势的优质胚胎率较降低趋势高;新鲜移植周期,P呈升高趋势时,HCG日P>1.0ng/ml,活产率下降;呈降低趋势时,HCG日P水平不影响活产率。
Objective: To investigate the effect of progesterone (P) level on the outcome of IVF-ET in the control of ovarian stimulation (COS). METHODS: A retrospective analysis of 676 cycles of IVF-ET long-term convalescent treatment at our center from January 2013 to June 2014 was performed. According to the change of progesterone on the start day of late follicular phase (the dominant follicle diameter is up to 13mm day) and the level of human chorionic gonadotropin (HCG) on the day of injection, it is divided into increasing tendency group and decreasing tendency group; (P≤1ng / ml), group B (P> 1ng / ml) and group C (P≤1ng / ml), respectively. / ml), D group (P> 1ng / ml). Results: (1) There was significant difference in the cleavage rate and the high quality embryo rate between elevated trend group and reduced trend group (99.65% vs 99.00%, 70.57% vs 63.09%, P <0.05); (2) A The clinical pregnancy rate and live birth rate in group B and group B were significantly different (56% vs 43.00%; 50% vs 37.76%, P <0.05). The clinical pregnancy rate and live birth rate in group C and group D The difference was not statistically significant (P> 0.05). CONCLUSION: During the long term cycle of IVF-ET, the rate of high-quality embryos with a rising trend of progesterone in COS is higher than that in COS. In the period of fresh transplantation, when P is increasing, HCG day is> 1.0ng / ml, The yield decreased; when the decreasing trend, the P level of HCG day did not affect the live birth rate.