摘要
目的分析卵巢低反应患者自然周期体外受精（IVF）方案中发生取卵前卵母细胞提早排出的相关因素，探讨预测和预防卵母细胞在取卵前提早排出的相关指标。方法实施自然周期IVF／卵胞浆内单精子注射（ICSI）治疗的患者共378个周期，自月经第3天B超监测窦卵泡直径，基础卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）值；第8～11天B超监测卵泡直径；当卵泡直径〉14mm时，监测血LH、E2、孕酮（P）水平，当E2≈1，100pmol／L时，肌注0．2mg促性腺激素释放激素激动剂（GnRH～a）诱发排卵（trigger），34～36h后取卵。分析各项临床指标与卵母细胞在取卵前提早排出发生的相关性。结果取卵前卵母细胞提早排出与基础E2值、“trigger”日P、LH值有关，与患者年龄、基础LH、FSH值和卵泡直径无关。结论自然周期取卵时机的选择应根据患者基础E2值及监测P、LH水平进行预测和监控。
Objective： To investigate the factors related to pre-ovulation in natural cycle, and explore a proper timing for oocyte retrieval. Methods： The basal background data including age, serum estradiol（E2 ）,FSH and LH levels on Day 3,and follicles diameters from 378 IVF/ICSI cycles of poor responders were analyzed. Diameters of follicles were measured by ultrasonography on Day 8. And LH,E2and progesterone（P）levels were assayed every morning when follicule diameter≥ 14 ram. Maturation was triggered by using 0.2 mg GnRH agonist intramuscular injection when E2 concentration reached 1,100 pmol/L. The oocytes were retrieved after 34- 36 hours. The correlation between clinical index and pre-ovulation occurrence in nature IVF/ICSI cycles were analyzed. Results： Pre-ovulation occurrence has a relationship with basal E2 concentration, P and LH levels on triggering day,rather than basal LH or FSH levels or follicle diameter. Conclusions： Timing of oocyte retrieval in nature cycle should be based on the monitoring of basal E2, P and LH levels of patients.
出处
《生殖医学杂志》
CAS
2014年第1期16-19,共4页
Journal of Reproductive Medicine
基金
江苏省临床医学科技专项(BL2012009)
省卫生厅科教兴卫工程(ZX201110)
国家临床重点专科(妇科)资助
