The effect of progesterone level prior to oocyte retrieval on the numbers of oocytes retrieved and embryo quality in IVF treatment cycles: an analysis of 2,978 cycles
The effect of progesterone level prior to oocyte retrieval on the numbers of oocytes retrieved and embryo quality in IVF treatment cycles: an analysis of 2,978 cycles
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DOI：
10.1007/s10815-014-0291-3
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发表时间：
2014-07
影响因子：
3.1
通讯作者：
Haiyan Zhu;Liu Liu-Liu;Ling-yun Yang;Yamei Xue;X. Tong;Lingying Jiang;Songying Zhang
中科院分区：
文献类型：
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作者：
Haiyan Zhu;Liu Liu-Liu;Ling-yun Yang;Yamei Xue;X. Tong;Lingying Jiang;Songying Zhang
目的探讨人绒毛膜促性腺激素(HCG)治疗后血清孕酮(P4)水平与新鲜体外受精周期中获卵数及胚胎质量的关系。比较hCG后血清P4水平与hCG触发当天的P4水平。患者分别采用长方案和短方案进行分析。此外，根据hCG P4治疗后的反应对患者进行分层。取回的卵母细胞数量和胚胎质量是主要的关注结果。结果2,978个体外受精周期中，2,484个周期为长周期方案，494个周期为短方案周期。在调整了患者年龄、促卵泡激素持续时间和基础促卵泡激素水平后，在长方案和短方案中，注射hCG后的P4反应和取卵数量(P<； 0.001)之间的相关性仍然具有统计学意义。此外，在调整相同因素后，成熟卵细胞率、受精率、优质胚胎率、妊娠率和种植率与P4的升高没有显著相关性。结论人绒毛膜促性腺激素P4水平与取卵数呈正相关，但不影响卵母细胞或胚胎质量。我们的研究表明，hCG后P4水平的变化是临床医生评估取卵数量的另一个参数，并可能进一步间接估计妊娠率和活产率。
PurposeThe study was designed to evaluate the relationship between serum progesterone (P4) response after hCG administration and the number of oocytes retrieved and the embryo quality in fresh IVF cycles.MethodsWe conducted a retrospective cohort study of women aged 24–43 years who underwent first fresh IVF cycle from 2011 to 2013 at a single practice. We compared the post-hCG serum P4 level with values on the day of hCG trigger. Patients were analyzed in long and short protocols independently. In addition, patients were stratified by post-hCG P4 response. Number of oocytes retrieved and embryo quality were the primary outcomes of interest. Ordinary least square regression models and logistic regression analysis models were created to identify predictive factors associated with embryological outcomes while adjusting for potential confounders.ResultsAmong the 2,978 IVF cycles, 2,484 patients were in long protocols, and 494 patients were in short protocols. After adjusting for patient age, rFSH duration, and basal FSH levels, the associations between P4 response after hCG administration and number of oocytes retrieved (P< 0.001) remained statistically significant in both long and short protocols. Additionally, mature oocyte rate, fertilization rate, good quality embryo rate, pregnancy rate and implantation rate were not significantly associated with the P4 increase when adjusting for the same factors. However, pregnancy rate and implantation rate from frozen-thawed cycles increased gradually across the seven groups.ConclusionsPost-hCG P4 levels were positively associated with the number of oocytes retrieved, but did not affect oocyte or embryo quality. Our study suggests that the change in the post-hCG P4 level is another parameter that can be used by clinicians to assess the number of oocytes retrieved, and may further to estimate the pregnancy rate and live birth rate indirectly.