[The relationship between serum concentration of free estradiol and free progesterone and establishment of pregnancy in in vitro fertilization-embryo transfer].

Nihon Sanka Fujinka Gakkai zasshi Pub Date : 1996-11-01
H Aoe
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Abstract

The aim of this study was to elucidate the roles of free estradiol and free progesterone in endometrial development and the outcome of IVF-ET. Ovarian hyperstimulation with long GnRHa-hMG protocol was performed for IVF-ET. Proliferation and maturation in endometrium was evaluated by transvaginal sonography. Total steroid hormone levels in serum were determined by EIA and free steroid hormone levels were determined by ultrafiltration dialysis. Total estradiol and total progesterone levels were significantly higher in conception cycles than that in non-conception cycles after Day 14 (Day 0 is the day of hCG administration). In the case of free estradiol and free progesterone, the difference was seen as early as Day 11. The hyperechoic endometrial area ratios, which represent endometrial maturation, evaluated by sonography on Day 2 in conception cycles (75%) were higher than those in non-conception cycles (56%), although there was no difference in total estradiol and total progesterone levels on Day -2, 1, 2, but the percentage of free progesterone in conception cycles (2.5%) was higher after Day 1 than that in non-conception cycles (2.0%). These results suggest that the percentage of free progesterone played an important role in successful conception and could be an indicator to estimate conception.

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体外受精-胚胎移植患者血清游离雌二醇、游离孕酮浓度与妊娠建立的关系。
本研究的目的是阐明游离雌二醇和游离黄体酮在子宫内膜发育和IVF-ET结局中的作用。IVF-ET采用长gnha - hmg方案进行卵巢过度刺激。经阴道超声检查子宫内膜的增殖和成熟情况。采用EIA法测定血清总类固醇激素水平,超滤透析法测定游离类固醇激素水平。妊娠周期总雌二醇和总孕酮水平在第14天(第0天为hCG给药日)后显著高于非妊娠周期。在游离雌二醇和游离黄体酮的情况下,差异早在第11天就被发现了。妊娠周期第2天超声评估的高回声子宫内膜面积比(代表子宫内膜成熟程度)(75%)高于非妊娠周期(56%),尽管第2、1、2天总雌二醇和总孕酮水平没有差异,但妊娠周期第1天后游离孕酮百分比(2.5%)高于非妊娠周期(2.0%)。这些结果表明游离孕酮的百分比在成功受孕中起重要作用,可以作为估计受孕的指标。
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