【摘要】 目的:评估血清雌二醇（E₂）、孕酮（P）水平和P/E₂与体外受精/卵胞浆内单精子注射（IVF/ICSI）并行GnRH长效激动剂方案妊娠结局间的关系。方法:对2014年1月至2017年2月期间接受IVF/ICSI新鲜周期胚胎移植并行Gn RH长激动剂方案的539例妇女的完整数据进行了回顾分析。根据获得的卵母细胞的数目分成3组:低卵巢反应（≤4个获得的卵母细胞）、中卵巢反应（获得5¹9个卵母细胞）和高卵巢反应（≥20个获得的卵母细胞）。采用受试者工作特征曲线（ROC曲线）确定hCG日血清P水平和P/E₂对不良妊娠预测的最佳临界值。结果:随着hCG日血清P水平的增加,妊娠率呈显著下降趋势;总体P水平为3.408 nmol/L,等效灵敏度和特异度值为55%;中和高卵巢反应者P水平为3.408 nmol/L的等效灵敏度和特异性值为56%,P水平为4.042 nmol/L的等效灵敏度和特异性值为62%。P/E₂≤0.49患者的妊娠率（31.4%）显著高于P/E2>0.49患者（23.4%）（P=0.041）,但是两者在受精率和卵裂率方面差异无统计学意义（P>0.05）。hCG日不同E₂水平患者妊娠率、受精率和卵裂率差异无统计学意义（P>0.05）。结论:hCG日血清P水平和P/E₂比值对IVF/ICSI并行GnRH长效激动剂方案妊娠结局有预测作用。更多还原

【Abstract】 Objective: To evaluate the association between serum P,E₂ and progesterone/estradiol ratio（ P/E₂） on pregnancy outcome in IVF/ICSI cycles with long agonist protocol. Methods: A review of complete data of 539 women underwent fresh IVF/ICSI cycles with long agonist protocol from January 2014 to February 2017 was done.Data were stratified into three groups according to the number of oocytes retrieved: low（ ≤4 oocytes obtained）,intermediate（ 5-19 oocytes obtained）,and high ovarian response（ ≥20 oocytes obtained） group.Receiver operating characteristics curve（ ROC curve） analysis was performed to determine the cut-off value for P and P/E₂ detrimental for pregnancy.Results:.With the increase of serum P level on daily h CG,the pregnancy rate was gradually decreased.The overall P level was 3. 408 nmol/L,with the equivalent sensitivity and specifity were 55%,The P level of moderate and high responders was 3. 408 nmol/L,with the equivalent sensitivity and specifity were 56%.Equivalent sensitivity and specificity of 62% for P level of 4. 042 nmol/L.The pregnancy rate（ 31. 4%） in patients with P/E₂≤0. 49 was significantly higher than that in patients（ 23. 4%） with P/E₂> 0. 49（ P = 0. 041）,but there was no significant difference in fertilization rate and cleavage rate between them（ P>0. 05）.Pregnancy rate,fertilization rate and cleavage rate at different E₂ levels on daily h CG also had no statistical significance（ P>0. 05）.Conclusions: Level of serum P and P/E₂ ratio on the day of human chorionic gonadotropin both are significant predictors for pregnancy outcome in IVF/ICSI cycles with long agonist protocol.更多还原