THE INFLUENCE OF SUPRAPHYSIOLOGICAL ESTRADIOL LEVELS ON HUMAN NIDATION

被引：36

作者：

GELETY, TJ ^{[1
]}

BUYALOS, RP ^{[1
]}

机构：

[1] UNIV ARIZONA,SCH MED,DEPT OBSTET & GYNAECOL,DEPT REPROD ENDOCRINOL & INFERTIL,TUCSON,AZ 85724

来源：

JOURNAL OF ASSISTED REPRODUCTION AND GENETICS | 1995年 / 12卷 / 07期

关键词：

IN VITRO FERTILIZATION; ESTRADIOL; FERTILIZATION RATES; PREGNANCY RATES;

D O I：

10.1007/BF02211139

中图分类号：

Q3 [遗传学];

学科分类号：

071007 ; 090102 ;

摘要：

Objective: Exogenous estradiol (E(2)) has a well-recognized interceptive action when administered shortly after ovulation. The influence of extremely elevated levels of endogenous E(2) on human oocyte fertilization and implantation are unclear. The purpose of this study was to evaluate a potential antinidatory role of extremely high endogenous E(2) concentrations on implantation and pregnancy during in vitro fertilization-embryo transfer (IVF-ET). Methods: Twenty-five patients receiving human menopausal gonadotropins (hMG) following midluteal GnRHa administration for IVF-ET, in which the maximal E(2) concentration was >5000 pg/ml (range 5358-16,344 pg/ml) were studied. Cycle parameters including oocyte and embryo characteristics, fertilization, cleavage, and implantation rates as well as pregnancy outcomes were compared to those of 25 patients treated contemporaneously whose treatment cycles had peak E(2) values <3500 pg/ml, Patients groups were matched for age, infertility diagnoses, duration of infertility and stimulation protocol. Results: Cycles characterized by very high endogenous E(2) levels resulted in significantly more oocytes per retrieval (21.4 +/- 1.7 versus 8.4 +/- 0.6; P < 0.0001), fewer postmature oocytes (1.6% +/- 1.0% versus 14% +/- 5.0%; P < 0.03), and a decreased fertilization rate (63% +/- 4.0% versus 73% +/- 3.0%; P < 0.04) compared to control cycles. There were no differences in the overall mean morphologic grade or cleavage rates between groups, However, high E(2) cycles were associated with a significantly increased implantation rate (14% +/- 4.0% versus 8.0% +/- 4.0%; P < 0.01) and pregnancy rate per embryo transfer (62% +/- 16% versus 36% +/- 16%; P < 0.01) compared to controls, The incidence of spontaneous abortion did not differ between groups. Conclusions: Extremely high endogenous E(2) levels do not appear to adversely affect implantation or overall cycle pregnancy rates in IVF-ET cycles. However, impaired fertilization rates in such cycles support a potential adverse effect on oocyte quality.

引用

页码：406 / 412

页数：7

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