{"title":"在卵泡期长方案中，年轻女性是否有必要在人绒毛膜促性腺激素(HCG)日监测血清黄体生成素(LH)浓度?回顾性队列研究。","authors":"Wenjuan Zhang, Zhaozhao Liu, Manman Liu, Jiaheng Li, Yichun Guan","doi":"10.1186/s12958-022-00888-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The normal physiological function of LH requires a certain concentration range, but because of pituitary desensitization, even on the day of HCG, endogenous levels of LH are low in the follicular-phase long protocol. Therefore, our study aimed to determine whether it is necessary to monitor serum LH concentrations on the day of HCG (LH<sub>HCG</sub>) and to determine whether there is an optimal LH<sub>HCG</sub> range to achieve the desired clinical outcome.</p><p><strong>Methods: </strong>A retrospective cohort study included 4502 cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) from January 1, 2016, to June 30, 2019, in a single department. The main outcome measures included retrieved eggs, available embryos, and live birth rate.</p><p><strong>Results: </strong>The LH<sub>HCG</sub> was divided into five groups: Group A (LH ≤ 0.5), Group B (0.5 IU/L < LH ≤ 1.2 IU/L), Group C (1.2 IU/L < LH ≤ 2.0 IU/L), Group D (2.0 IU/L < LH ≤ 5.0 IU/L), Group E (LH > 5 IU/L). In terms of the numbers of retrieved eggs (15.22 ± 5.66 vs. 13.54 ± 5.23 vs. 12.90 ± 5.05 vs. 12.30 ± 4.88 vs. 9.6 ± 4.09), diploid fertilized oocytes (9.85 ± 4.70 vs. 8.69 ± 4.41 vs. 8.39 ± 4.33 vs. 7.78 ± 3.96 vs. 5.92 ± 2.78), embryos (7.90 ± 4.48 vs. 6.83 ± 4.03 vs. 6.44 ± 3.88 vs. 6.22 ± 3.62 vs. 4.40 ± 2.55), and high-quality embryos (4.32 ± 3.71 vs. 3.97 ± 3.42 vs. 3.76 ± 3.19 vs. 3.71 ± 3.04 vs. 2.52 ± 2.27), an increase in the LH<sub>HCG</sub> level showed a trend of a gradual decrease. However, there was no significant difference in clinical outcomes among the groups (66.67% vs. 64.33% vs. 63.21% vs. 64.48% vs. 63.33%). By adjusting for confounding factors, with an increase in LH<sub>HCG</sub>, the number of retrieved eggs decreased (OR: -0.351 95%CI - 0.453-[- 0.249]).</p><p><strong>Conclusion: </strong>In the follicular-phase long protocol among young women, monitoring LH<sub>HCG</sub> is recommended in the clinical guidelines to obtain the ideal number of eggs.</p>","PeriodicalId":520764,"journal":{"name":"Reproductive biology and endocrinology : RB&E","volume":" ","pages":"24"},"PeriodicalIF":0.0000,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808976/pdf/","citationCount":"2","resultStr":"{\"title\":\"Is it necessary to monitor the serum luteinizing hormone (LH) concentration on the human chorionic gonadotropin (HCG) day among young women during the follicular-phase long protocol? 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The main outcome measures included retrieved eggs, available embryos, and live birth rate.</p><p><strong>Results: </strong>The LH<sub>HCG</sub> was divided into five groups: Group A (LH ≤ 0.5), Group B (0.5 IU/L < LH ≤ 1.2 IU/L), Group C (1.2 IU/L < LH ≤ 2.0 IU/L), Group D (2.0 IU/L < LH ≤ 5.0 IU/L), Group E (LH > 5 IU/L). In terms of the numbers of retrieved eggs (15.22 ± 5.66 vs. 13.54 ± 5.23 vs. 12.90 ± 5.05 vs. 12.30 ± 4.88 vs. 9.6 ± 4.09), diploid fertilized oocytes (9.85 ± 4.70 vs. 8.69 ± 4.41 vs. 8.39 ± 4.33 vs. 7.78 ± 3.96 vs. 5.92 ± 2.78), embryos (7.90 ± 4.48 vs. 6.83 ± 4.03 vs. 6.44 ± 3.88 vs. 6.22 ± 3.62 vs. 4.40 ± 2.55), and high-quality embryos (4.32 ± 3.71 vs. 3.97 ± 3.42 vs. 3.76 ± 3.19 vs. 3.71 ± 3.04 vs. 2.52 ± 2.27), an increase in the LH<sub>HCG</sub> level showed a trend of a gradual decrease. However, there was no significant difference in clinical outcomes among the groups (66.67% vs. 64.33% vs. 63.21% vs. 64.48% vs. 63.33%). By adjusting for confounding factors, with an increase in LH<sub>HCG</sub>, the number of retrieved eggs decreased (OR: -0.351 95%CI - 0.453-[- 0.249]).</p><p><strong>Conclusion: </strong>In the follicular-phase long protocol among young women, monitoring LH<sub>HCG</sub> is recommended in the clinical guidelines to obtain the ideal number of eggs.</p>\",\"PeriodicalId\":520764,\"journal\":{\"name\":\"Reproductive biology and endocrinology : RB&E\",\"volume\":\" \",\"pages\":\"24\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-02-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808976/pdf/\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reproductive biology and endocrinology : RB&E\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12958-022-00888-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive biology and endocrinology : RB&E","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12958-022-00888-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 2
摘要
背景:LH的正常生理功能需要一定的浓度范围，但由于垂体脱敏，即使在HCG当天，卵泡期长方案中内源性LH水平较低。因此，我们的研究旨在确定是否有必要监测HCG (LHHCG)当天的血清LH浓度，并确定是否存在一个最佳的LHHCG范围，以达到理想的临床效果。方法:回顾性队列研究包括2016年1月1日至2019年6月30日在同一科室进行的4502周期体外受精(IVF)/胞浆内单精子注射(ICSI)。主要结局指标包括取卵、可用胚胎和活产率。结果:LHHCG分为5组:A组(LH≤0.5)，B组(0.5 IU/L 5 IU/L)。的检索鸡蛋的数量(15.22±5.66和13.54±5.23和12.90±5.05和12.30±4.88和9.6±4.09),二倍体卵子受精(9.85±4.70和8.69±4.41和8.39±4.33和7.78±3.96和5.92±2.78),胚胎(7.90±4.48和6.83±4.03和6.44±3.88和6.22±3.62和4.40±2.55),和高质量的胚胎(4.32±3.71和3.97±3.42和3.76±3.19和3.71±3.04和2.52±2.27),增加LHHCG水平逐步下降的趋势。但两组临床结局差异无统计学意义(66.67% vs. 64.33% vs. 63.21% vs. 64.48% vs. 63.33%)。通过调整混杂因素，随着LHHCG的增加，取卵数量减少(OR: -0.351 95%CI - 0.453-[- 0.249])。结论:在年轻女性卵泡期长方案中，临床指南建议监测LHHCG以获得理想的卵子数量。
Is it necessary to monitor the serum luteinizing hormone (LH) concentration on the human chorionic gonadotropin (HCG) day among young women during the follicular-phase long protocol? A retrospective cohort study.
Background: The normal physiological function of LH requires a certain concentration range, but because of pituitary desensitization, even on the day of HCG, endogenous levels of LH are low in the follicular-phase long protocol. Therefore, our study aimed to determine whether it is necessary to monitor serum LH concentrations on the day of HCG (LHHCG) and to determine whether there is an optimal LHHCG range to achieve the desired clinical outcome.
Methods: A retrospective cohort study included 4502 cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) from January 1, 2016, to June 30, 2019, in a single department. The main outcome measures included retrieved eggs, available embryos, and live birth rate.
Results: The LHHCG was divided into five groups: Group A (LH ≤ 0.5), Group B (0.5 IU/L < LH ≤ 1.2 IU/L), Group C (1.2 IU/L < LH ≤ 2.0 IU/L), Group D (2.0 IU/L < LH ≤ 5.0 IU/L), Group E (LH > 5 IU/L). In terms of the numbers of retrieved eggs (15.22 ± 5.66 vs. 13.54 ± 5.23 vs. 12.90 ± 5.05 vs. 12.30 ± 4.88 vs. 9.6 ± 4.09), diploid fertilized oocytes (9.85 ± 4.70 vs. 8.69 ± 4.41 vs. 8.39 ± 4.33 vs. 7.78 ± 3.96 vs. 5.92 ± 2.78), embryos (7.90 ± 4.48 vs. 6.83 ± 4.03 vs. 6.44 ± 3.88 vs. 6.22 ± 3.62 vs. 4.40 ± 2.55), and high-quality embryos (4.32 ± 3.71 vs. 3.97 ± 3.42 vs. 3.76 ± 3.19 vs. 3.71 ± 3.04 vs. 2.52 ± 2.27), an increase in the LHHCG level showed a trend of a gradual decrease. However, there was no significant difference in clinical outcomes among the groups (66.67% vs. 64.33% vs. 63.21% vs. 64.48% vs. 63.33%). By adjusting for confounding factors, with an increase in LHHCG, the number of retrieved eggs decreased (OR: -0.351 95%CI - 0.453-[- 0.249]).
Conclusion: In the follicular-phase long protocol among young women, monitoring LHHCG is recommended in the clinical guidelines to obtain the ideal number of eggs.
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