生殖医学杂志

<正>近年来的文献报道,我国某些地区有生育要求的育龄夫妇中不孕症的发病率接近10%。不育对患者身心健康的影响越来越得到社会的关注,而辅助生殖技术(assisted reproductive treatment,ART)作为目前不孕症治疗的常用方法之一,近10年来在我国的应用发展迅速,各种衍生技术的治疗成功率均达到国际先进水平,但临床妊娠率始终维持在30%~40%,活产率在25%左右,难以得到进一步提高,故临床医生进行了大量临床研究,希望能够获得预测体外受精-胚胎移植(IVF-ET)治疗结局的血

We have previous studied the relationship between serum progesterone(P)/estradiol(E₂) concentrations and IVF pregnancy outcomes in gonadotropin-releasing hormone agonist(GnRH-a)protocols.The data of 251 infertile patients undergone IVF-ET with GnRH-a and recombinant FSH(rFSH) were prospectively analyzed.It showed that the pregnancy rate was significantly lower when the serum progesterone concentration on HCG day was ≥ 3.97 nmol/L.The incidence of progesterone elevation was 36.7%.If the serum progesterone on HCG day was>6.0 nmol/L,the pregnancy outcome was much poorer:however,the pregnancy rate was similar in frozen embryo transfer(FET)cycles.Another study suggested that elevated P and E₂ levels had lower clinical pregnancy and live birth rates as well as the highest ectopic pregnancy rate.We also found that there were 4 miRNA(all downregulated)and 22 mRNA(13 up-regulated and 9 down-regulated) exhibiting differential expression between the groups on the microRNA and microarray chips.Osteopontin and vascular endothelial growth factor(VEGF) were shown to have positive expression in the endometrium.Combined with other reports,our studies data suggests that endometrial receptivity may be dissimilar in patients with high P levels on HCG day.Frozen-thawed embryo transfer should be suggested to improve these patients' pregnancy outcomes.