长方案添加重组人黄体生成素对IVF-ET结局的影响

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Abstract Objective To investigate the influence of adding recombinant human luteinizing hormone(r-hLH)on In vitro fertilization-embryo transfer(IVF-ET)outcome in superovulation of long protocol.Methods A total of 538 infertile patients given long protocol of IVF-ET in Reproductive Medical Center of the Third Affiliated Hospital in Guangxi Medical University from February 2012 to December 2015 were selected.According to their serum LH level on gonadotropin(Gn)initial day,all patients were divided into the two groups:group A(n=238):LH＜0.5 mIU/ml and group B (n=300):LH>0.5 mIU/ml,and then according to different methods of adding r-hLH,they were divided into the different subgroups:group A was divided into group A1(n=72,adding rLH from the first day of Gn)and group A2(n=166,adding rLH from the eighth day of Gn.Group B was divided into group B1 (n=137,using only FSH,without r-hLH)and group B2(n=163,adding rLH from the eighth day of Gn).The basic information,main laboratory indexes and clinical outcomes were compared among four groups.Results Compared with group A2,the durations of Gn in group A1 was shorter,and there was a statistical difference(P<0.05).The serum E2 level on the day of hCG,high-quality embryo rate,implantation rate and clinical pregnancy rate in group A1 were higher than those in group A2,and there were statistical differences(P<0.05).The dosage of Gn in group B2 was fewer than that in group B1,and there was a statistical difference (P<0.05).The normal fertilization rate(2PN),high-quality embryo rate and clinical pregnancy rate in B1 group were higher than those in group B2,and there were statistical differences(P<0.05).The dosage of Gn in group A2 was higher than that in group B2(P<0.05),and the E2level and LH level on hCG day in group A2 were lower than those in group B2,and there were statistical differences(P<0.05),and the clinical pregnancy rate in group A2 was significantly higher than that in group B2,and there was a statistical difference(P<0.05).Conclusion For those patients with ages younger than 35 years old and serum LH level＜0.5 mIU/ml on Gn initial day,early adding r-hLH may shorten the durations of Gn,raise the E2 level of hCG day,increase the high-quality embryo rate,implantation rate and clinical pregnancy rate.But for patients with LH≥0.5 mIU/ml,adding r-hLH is not beneficial to the clinical outcomes.

Key words： In vitro fertilization-embryo transfer Rrecombinant human luteinzing hormone Controlled ovulation hyperstimulation Pregnancy rate

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	NONG Liu-ying
	TAN Xiu-qun

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NONG Liu-ying,TAN Xiu-qun. Influence of adding recombinant human luteinizing hormone on IVF-ET outcome in long protocol[J]. 中国当代医药, 2018, 25(24): 12-16.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I24/12

[1]	Porter RN，Smith W，Craft IL，et al.Induction of ovulation for in-vitro fertilisation using buserelin and gonadotropins[J].Lancet，1984，324（8414）：1284-1285.
[2]	胡琳莉，孙莹璞.不同促排卵方案对于体外受精-胚胎移植结局的影响[J].实用妇产科杂志，2014，30（10）：723-725.
[3]	滕忻园.黄体生成素在基础LH<1U/L患者在体外授精-胚胎移植过程中的应用[D].杭州：浙江大学，2015.
[4]	李颂军，沈秀，周睿琼，等.重组人黄体生成素添加时机对改良超长方案IVF/ICSI结局的影响[J].生殖医学杂志，2016，25（11）：977-982.
[5]	邓宇，尹敏娜，梁佩玲，等.长方案添加黄体生成素对体外受精-胚胎移植结局的影响[J].南方医科大学学报，2017，37（11）：1501-1505.
[6]	Bleau N，Agdi M，Son WY，et al.A Comparison of outcomes from in vitro fertilization cycles stimulated with either recombinant luteinizing hormone or human menopausal gonadotropins in subjects treated with long gonadotropin releasing hormone agonist protocols，a retrospective analysis[J].Int J Fertil Steril，2017，11（2）： 79-84.
[10]	靳镭，徐蓓.黄体生成素在卵泡发育中的作用及早卵泡期黄体生成素预处理[J].生殖医学杂志，2014，23（12）：940-943.
[11]	蒋秀敏，刘雨生，郑圣霞，等.长方案超促排卵过程中LH变化趋势对IVF/ICSI-ET结局的影响[J].生殖与避孕，2015，35（1）：30-36.
[12]	李巍巍，许晓燕，高瑞峰，等.长方案促排卵过程中血清LH低于正常值时补充LH对助孕结局的影响[J].华中科技大学学报（医学版），2015，44（3）：334-338.
[13]	高文丽.辅助生殖技术中不同时机r-LH的添加对IVF妊娠结局的影响[D].银川：宁夏医科大学，2016.
[7]	Gardner DK，Schoolcraft WB，Wagley L，et al.A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization[J].Hum Reprod，1998，13（12）：3434-3440.
[8]	Balasch J，Fabregues F.Is luteinizing hormone needed for optimal ovulation induction?[J].Curr Opin Obstet Gynecol，2002，14（3）：265-274.
[9]	Borini A，Dal Prato L.Tailoring FSH and LH administration to individual patients[J].Reprod Biomed Online，2005，11（3）：283-293．
[14]	Alsbjerg B，Elbaek HO，Laursen RJ，et al.Bio-equivalent dosesof recombinant HCGand recombinant LH duringovarian stimulation result in similar oestradiol output：arandomized controlled study[J].Reprod Biomed Online，2017，35（2）：232-238.
[15]	姜玉滢.卵泡发育及辅助生殖促排卵中促黄体生成素的作用研究[J].医学信息，2018，（3）：101-102.
[16]	田莉峰，伍琼芳，谭俊，等.早卵泡期长方案血清LH低的患者添加r-LH的临床结局分析[J].生殖医学杂志，2018，（4）：310-315.
[17]	Fleming R，Lloyd F，Herbert M，et al.Effects of profound suppression of luteinizing hormone during ovarian stimulation on follicular activity，oocyte and embryo function in cycles stimulated with purified follicle stimulating hormone[J].Hum Reprod，1998，13（7）：1788-1792.
[18]	Westergaard LG，Laursen SB，Andersen CY.Increased risk of early pregnancy loss by profound suppression of luteinizing hormone during ovarian stimulation in normogonadotrophic women undergoing assisted reproduction[J].Hum Reprod，2000，15（5）：1003-1008.
[19]	李洁，刘倍余.识别促性腺激素释放激素激动剂对垂体-卵巢轴降调节抑制程度及意义[J].生殖医学杂志，2011，20（Z1）：17-20.
[20]	许丽华，车小群，庞小艳，等.辅助生殖技术超促排卵中血清促黄体生成素对胚胎移植中妊娠结局的影响[J].中国当代医药，2014，21（12）：184-186.
[21]	梁璐怡.IVF-ET降调节后LH及取卵日卵泡液BDNF水平在卵泡发育同步性方面的研究[D].南昌：南昌大学，2015.
[22]	周晓景，谭丽，王芳，等.多囊卵巢综合征患者改良超长方案启动日血清LH水平与IVF-ET结局的关系[J].中国医师杂志，2017，19（3）：421-423.
[23]	骆丽华，刘雨生，季静娟，等．长方案卵巢刺激启动日血黄体生成激素水平作为黄体生成激素添加指标的价值[J].中国实用妇科与产科杂志，2012，28（8）：619-623.
[24]	靳镭，徐蓓.黄体生成素在卵泡发育中的作用及早卵泡期黄体生成素预处理[J].生殖医学杂志，2014，23（12）：940-943.
[25]	牛海燕，郭艺红.重组人促黄体生成素在IVF促排卵中的研究[J].河南医学研究，2014，23（3）：90-92.
[26]	陈苹.不同水平黄体生成素对自然排卵周期激素水平及卵泡发育的影响[D].北京：首都医科大学，2016.
[27]	谭真，李洁，李涛，等.黄体生成素在人类卵母细胞和种植前胚胎的表达[J].中山大学学报（医学科学版），2006，23（z1）：44-46.
[28]	殷莉，朱桂金.控制性超排卵中黄体生成素的过度抑制和黄体生成素预处理[J].生殖医学杂志，2013，22（10）：749-752.
[29]	Alviggi C，Clarizia R，Mollo A，et al.Who needs LH in ovarian stimulation?[J].Reprod Biomed Online，2006，12（5）：599-607.
[30]	马兰，陈潇，李红.长方案促排卵中期添加黄体生成素对助孕结局的影响[J].生殖与避孕，2013，33（7）：485-490.
[31]	黄静，姜宏，张文香，等．促性腺激素释放激素激动剂降调节后血清黄体生成素水平对体外受精-胚胎移植结局的影响[J].生殖医学杂志，2011，20（5）：356-359.
[32]	Garciavelasco JA，Bennink HJ，Epifanio R，et al.High-dose recombinant LH add-back strategy using high-dose GnRH antagonist is an innovative protocol compared with standard GnRH antagonist[J].Reprod Biomed Online，2007，15（3）：280-287.
[33]	曾海涛.高胰岛素水平和高LH/FSH比值对颗粒细胞/卵泡膜细胞的作用[D].广州：中山大学，2004.
[34]	赵芳，吕玉珍，王娟，等.长方案促排卵周期卵巢反应性与IVF-ET结局的关系[J].中国计划生育学杂志，2016，24（11）：767-771.
[35]	Bosch E，Labarta E，Crespo J，et al.Circulating progesterone levels and ongoing pregnancy rates in controlled ovarian stimulation cycles for invitro fertilization：analysis of over 4000 cycles[J].Hum Reprod，2010，25（8）：2092-2100.