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- 體外受精週期中卵巢刺激之早發性黃體化並不影響其懷孕結果Premature Luteinization during Ovarian Stimulation did not Affect Pregnancy Outcome in in Vitro Fertilization Cycles
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題 名 | 體外受精週期中卵巢刺激之早發性黃體化並不影響其懷孕結果Premature Luteinization during Ovarian Stimulation did not Affect Pregnancy Outcome in in Vitro Fertilization Cycles |
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作 者 | 楊政憲; 趙光漢; 吳明義; 陳欽德; 陳信孚; 陳思原; 何弘能; 楊友仕; | 書刊名 | 臺灣醫學 |
卷 期 | 2:1 1998.01[民87.01] |
頁 次 | 頁1-7 |
分類號 | 417.125 |
關鍵詞 | 體外受精; 早發性黃體化; 黃體素; 黃體化激素; In vitro fertilization; Premature luteinization; Progesterone; Luteinizing hormone; |
語 文 | 中文(Chinese) |
中文摘要 | 卵巢刺激之早發性黃體化在體外受精週期中並不罕見, 其影響層面與成因至今仍 不十分確定。 本研究係由 1996 年 1 月至 1997 年 10 月於本院接受體外受精助孕治療並 植入 2 ∼ 5 個胚胎之婦女中,扣除卵子捐贈以及沒有合併使用促性腺激素釋放素類似物( GnRHa )、人類停經促性腺激素( hMG )及濾泡刺激激素( FSH )刺激卵巢的病人,以所 餘 266 個週期的病人為統計對象。我們以注射人類絨毛促性腺激素( hCG )當天血清中黃 體素濃度 0.9 ng/mL 為界將前述病人分為二組, 其中濃度≦ 0.9 ng/mL 者共 113 個週期 ,濃度> 0.9 ng/mL 者(定義為早發性黃體化)共 153 個週期。再將接受經陰道胚胎植入 ( ET )與經輸卵管胚胎植入( TET )的病人分別統計,結果發現在 ET 週期中, 黃體素 濃度≦ 0.9 ng/mL 的懷孕率與著床率( 35.6 %及 10.2 %)高於濃度> 0.9 ng/mL 時( 24.2% 及 8.3% ),但無統計上顯著差異。在 TET 週期中,黃體素濃度≦ 0.9 ng/mL 與濃 度> 0.9 ng/mL 的懷孕率非常接近( 48.5 % vs. 49.5 %),著床率則前者較高( 18.9 % vs. 15.8 %)。此外,黃體素濃度> 0.9 ng/mL 時有較高的血清雌二醇( E �砥^濃度 ( ET 與 TET 週期,p 值< 0.005 )、血清黃體化激素( LH )濃度( ET 週期,p 值< 0.05 )、濾泡數( TET 週期,p 值< 0.05 )與取卵數( TET 週期, p 值< 0.01 )。 受精率、品質良好的卵子及胚胎之百分比均與黃體素濃度高低無關。接受體外受精治療的婦 女一旦懷孕,早期流產或子宮外孕的危險性並不因濾泡期之黃體素濃度升高而增加。我們的 結論是早發性黃體化常見於體外受精週期中濾泡數與取卵數較多時, 以及注射 hCG 當天 E �粉P LH 血清濃度較高的婦女,但它並不影響懷孕率與著床率。而且,發生早發性黃體化的 婦女一旦懷孕,其預後並不會較差。 |
英文摘要 | Premature luteinization during ovarian stimulation is common in in vitro fertilization (IVF) cycles. Its cause and possible deleterious effects are still under investigation. We retrospectively studied impact of premature luteinization in women undergoing IVF at National Taiwan University Hospital from 1996 January to 1997 October. Oocyte donors as well as women who did not receive gonadotropin releasing hormone analogue (GnRHa) combined with human menopausal gonadotropin (hMG) and follicle stimulating hormone (FSH) for ovarian stimulation were excluded from this study. There were 266 cycles in which women received 2 to 5 transferred embryos. Of these, there were 113 cycles with progesterone (P �� ) levels ≦ 0.9 ng/mL on the day of human chorionic gonadotropin (hCG) administration, and 153 cycles with P �� > 0.9 ng/mL (defined as premature luteinization). The data were analyzed separately in embryo transfer (ET) and tubal embryo transfer (TET) cycles. The results revealed that pregnancy rates were not significantly different between cycles with or without prementure luteinization, in either ET (35.6% vs. 24.2%) or TET (48.5% vs. 49.5%) cycles. Estradiol (E ��, p<0.005 in both ET and TET cycles) and luteinizing hormone (LH, p<0.005 in ET cycles) levels on the day of hCG administration as well as follicle (p < 0.05 in TET cycles) and oocyte (p<0.01 in TET cycles) numbers were apparently higher for women with prepmature luteinization. Nevertheless, the fertilization rate and the rates of good-quality oocytes and embryos were similar in cycles with and without premature luteninization. The incidences of early pregnancy loss and ectopic pregnancy were also similar between the two groups. We conclude that premature luteinization is associated with more recruited follicles and more retrieved oocytes as well as higher levels of E �� and LH on the day of hCG administration in IVF. However, P �� levels evidently do not affect the pregnancy rate and outcome. |
本系統中英文摘要資訊取自各篇刊載內容。