| Objective: ⑴To compare the serum concentration of Luteinizing Hormone(LH), Estradiol(E2) and Progesterone(P) in the day of Human Chorionic Gonadotropin(HCG) injection between the pregnant group and nonpregnant group,and analyze the relationship between them and the result of In Vitro Fertilization and Embryo Transfer(IVF-ET).⑵ To compare the concentration of Tumor Necrosis Factor-α(TNF-α) in the serum and follicular fluid(FF) between the pregnant group and nonpregnant group,analyze the relationship among TNF-α,LH, E2 and P. And to explore the influence of TNF-α on the result of IVF-ET. ⑶ To compare the three largest follicles' average diameter between the pregnant group and nonpregnant group,and analyze the relationship among them and the result of IVF-ET,the serum levels of LH, E2,and P.⑷ To evalue the impacts of the Cervical Score(CS), the endometrial thickness and pattern on the pregnancy result.⑸ To explore the optimum time of HCG administration.Methods: Retrospective study Sixty-four women, who had undergone IVF-ET in the second hospital of hebei medical university from Mar 2003 to Jan 2004 because of fallopian tubal factor infertility. The age of the patients was 24～40 years.The patients are allocated into pregnant group (n=21) and nonpregnant group (n=43) according to their pregnancy outcome. COH Protocol: Apply the COH long protocol. Gonadotropin Releasing Hormone (GnRHa: DecapeptyL) / Gonadotropin (Gonal-F) / Human Menopausal Gonadotropin (HMG) / Human Chorionic Gonadotropin (HCG). Laboratory Analysis: ⑴ Hormone assay: The hormones including LH, E2,and P in the serum were examined with immunoenzymetric assay. ⑵ TNF-α assay: The TNF-αin serum and FF were tested by Enzyme linked immunoabsorbent assay. ⑶ Ultrasound measurement: Measured the three largest follicles' average diameter, the endometrial thickness and pattern on the day of HCG administration by a transvaginal ultrasound. ⑷ Cervical Score: Evalued the cervical mucus on the day of HCG administration by the Insler Cervical Score.⑸ Oocytes quality: Evalued the oocytes quality based on the Marrs standard.Result: ⑴The mean level of serum LH(2.5±0.9 vesus1.4±1.2) and E2(3711.2±1285.8 vesus 1901.9±927.2) was significantly high in the pregnant group compare to the nonpregnant group(P<0.05,P<0.01); But the serum P level(1.1±0.7 vesus 1.7±1.1) in the pregnant group was lower than that in the nonpregnant group (P<0.05). ⑵The mean level of TNF-α in serum(24.3±7.4 vesus 18.2±7.9) and FF (31.3±7.0 vesus 24.0±8.5) of pregnant group was higher than that of the nonpregnant group(P<0.01).⑶ The endometrial pattern in the pregnant group was significantly different from that in the nonpregnant group(P<0.01).The pregnancy rates of pattern A,B,C were 44.7%, 30.8% and 0%,there were significantly difference among them(P<0.01). The endometrial thickness in the pregnant group(10.9±1.2 vesus 9.4±1.5) was thicker than that of the nonpregnant group(P<0.01).The endometrial thickness of all pregnancies was found to be ≥9mm.The CS(10.9±0.9 vesus 10.2±1.2) was higher than that in the nonpregnant group (P<0.05),the CS of all pregnancies was found to be ≥9 .⑷The three largest follicles' average diameter in the pregnant group (17.7±0.7 vesus 17.1±0.9, 17.1±0.7mm vesus 16.3±0.7, 16.3±0.7 vesus 16.4±0.9) was bigger than that of the nonpregnant group(P<0.01,P<0.01,P<0.05).When the first largest follicle's average diameter≥17.5mm,the second largest follicle's average diameter≥17.0mm,the third largest follicle's average diameter≥16.5mm ,there were high pregnancy rates. ⑸ The level of serum LH on the day of HCG administration was correlated positively with the average diameter of the three largest follicles (r=0.495,p<0.01; r=0.449,p<0.01 ; r=0.429,p<0.01) , the endometrial thickness (r=0.394,p<0.01) , the concentrations of TNF-αin serum and FF (r=0.603,p<0.01;r=0.641,p<0.01), the CS (r=0.386,p<0.01) , the number of oocytes collected (r=0.271,p<0.05), the fertilization rates (r=0.327,p<0.05), and the implantatio... |
PDF Full Text Request