【摘要】 目的:探讨黄体期小剂量补充雌激素对体外受精-胚胎移植(IVF-ET)结局的影响。方法:回顾性分析116个长方案IVF-ET周期,根据其移植日血清雌二醇(E2)水平下降幅度和雌激素剂量分为4组。A组,E2下降<30%,27个周期,单用孕激素进行黄体期支持。B组,E2下降30%～49%,45个周期,黄体期支持采用孕激素+2mg/d雌激素。C组,E2下降≥50%,29个周期,黄体期支持采用孕激素+2mg/d雌激素。D组,E2下降≥50%,15个周期,黄体期支持采用孕激素+4mg/d雌激素。结果:各组患者的年龄、获卵数、受精率、卵裂率、优质胚胎数、移植胚胎数和移植日内膜厚度之间差异无显著性(P>0.05)。A组、B组、D组间的临床妊娠率和胚胎种植率无统计学差异(P>0.05),而C组的临床妊娠率和胚胎种植率明显低于其余3组(P<0.05)。结论:在IVF-ET中,当移植日血清E2水平下降幅度≥30%时黄体期补充雌激素可以改善临床妊娠率和胚胎种植率。黄体期补充雌激素的剂量应根据E2的下降幅度而定,下降幅度≥50%的患者需要增加雌激素的补充剂量。更多还原

【Abstract】 Objective To explore the influence of low-dose estradiol supplementation during the luteal phase on the clinical outcome of in vitro fertilization and embryo transfer.Methods 116 long protocol IVF-ET cycles were retrospectively analzyed.The patients were divided into 4 groups according to the decreasing serum levels of E2 on the day of ET and the dosage of estradiol use.Group A:patients with 27 cycles and a declined E2 level < 30% received progesterone alone as the luteal phase support;group B:patients with 45 cycles and a decreased E2 level 30%-49% received progesterone combined with oral E2 of 2 mg / d;group C:patients with 29 cycles and a decreased E2 level ≥ 50% received the same therapy as group B;group D:patients with 15 cycles and a declined E2 level ≥50% received progesterone plus E2 of 4 mg / d.Results There were no differences among 4 groups in age, the number of ova harvested, fertilization rates, cleavage rates, the number of high-quality embryos and embryos transferred, and endometrial thickness on the day of ET(P > 0.05).The rates of embryo transfer and clinical pregnancy did not differ significantly among groups A, B, and D but were markedly lower in group C than in the other three groups(P < 0.05).Conclusions In IVF-ET cycles, estradiol supplementation during the luteal phase can improve the rates of clinical pregnancy and embryo transfer in patients with a declined E2 level ≥ 30% on the day of ET.The dosage of estradiol should be individualized according to the decreasing level of E2 and those with a declined E2 level ≥ 50% require an increase in estradiol use.更多还原