Conventional IVF でのlong protocol におけるhCG 投与日の血中progesterone 値と妊娠成績について

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  • Evaluation of the Influence of Serum Progesterone Levels, Measured on the Day of hCG Administration,Pregnancy Outcome, in a Conventional IVF:Long Protocol Stimulation
  • Conventional IVF デノ long protocol ニオケル hCG トウヨビ ノ ケッチュウ progesterone チ ト ニンシン セイセキ ニ ツイテ

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type:原著

type:Original

Long protocol(L)下でのconventional IVF(cIVF)において,hCG 切り替え日の血中progesterone(P)値とcIVF における種々の因子及び妊娠成績との関係について検討した.不妊外来を受診した患者で,L 下でcIVF を施行された486 例,706 周期を対象とした.hCG 切り替え日の血中P 値と血中estradiol(E2)値,総hMG 投与量,採卵数,正常受精(2PN)発生数,2PN 発生率,良好胚(G1)胚数,G1 胚発生率,子宮内膜厚(EM),leaf pattern の有無,妊娠率等との関係について検討した.P 値とE2 値,採卵数,2PN 発生数,G1胚数との間には,有意な正の相関関係が認められた(P<0.01).2PN 発生率との間には有意な負の相関関係が認められた(P<0.01).子宮内膜におけるleaf patternの有無を見ると,leaf( +)の群ではleaf( −)の群に比べ有意にP 値が低かった(P<0.01).また,P 値レベル別での妊娠率,多胎率,流産率の比較では,P 値2.1−2.5 ng/ml で妊娠率が有意に高かった(P<0.05).P 値レベルは,E2 値,採卵数,2PN 発生数およびG1 胚発生数と相関している.これらのことから,P 値レベルは卵胞成熟および卵のquality を示す一つのシグナルとなり得ることが明らかになった.一方,P 値レベルが子宮内膜の肥厚や妊娠率に影響していないことも判明した.

Objectives:The aim of this study was to evaluate thecorrelation between serum progesterone (P) levels on theday of hCG administration and various factors includingpregnancy outcome in a conventional IVF( cIVF) long protocolstimulation.Material and methods:Seven hundred six IVF cyclesusing a long protocol with GnRH agonist and hMG involving486 patients were studied. This study retrospectivelyevaluated the correlation of serum P levels on the day ofhCG administration with serum estradiol (E2) levels, totaldose of hMG, number of oocytes retrieved, number of normalfertilized oocytes, normal fertilized oocytes rate, numbersof high quality oocytes (G1), G1 rate, endometrialthickness, presence of endometrial leaf pattern and pregnancyoutcome in cIVF.Results:A significant positive correlation was observedbetween serum P levels on the day of hCG administrationand serum E2 levels, number of oocytes retrieved, numberof normal fertilized oocytes and numbers of G1,( p<0.01).A significant negative association was observed betweenserum P levels on the day of hCG administration and normalfertilized oocytes rate( p<0.01).Serum P levels on the day of hCG administration of theleaf( +) group( presence of endometrial leaf pattern) wassignificantly low in comparison with that of the leaf (−)group( p<0.01).Among the six groups, the pregnancy ratein P levels from 2.1 to 2.5 ng/ml was significantly high incomparison with others.Conclusion:A significant positive correlation was observedbetween serum P levels on the day of hCG administrationand E2 levels, number of oocytes retrieved, numberof normal fertilized oocytes and numbers of G1. Among thesix groups, the pregnancy rate in P levels from 2.1 to 2.5ng/ml was significantly high in comparison with others. Accordingto two above-mentioned results, we conclude thatan appropriate P levels is important for oocyte maturation.

identifier:11

identifier:KJ00006989739

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