■评估孕激素给药之前血清LH水平对程序性冻融胚胎移植(FET)周期结果的影响。
进行回顾性队列研究,根据596个周期的518例接受FET人工子宫内膜准备方案的患者孕激素给药前血清LH水平的25百分位数,比较四组之间的治疗结果。主要结果指标是持续和活产率。次要结局指标是怀孕率,临床妊娠率,和怀孕损失率。
■临床妊娠(CPR)和活产率(LBR)的趋势从孕激素给药前血清LH水平的第一四分位数增加到第四四分位数(Q1到Q4)(37,0%至48,3%,p=0.042,22.6%到39.5%,分别,p=0.003)。Q1组的妊娠损失率(PLR)较高,尽管差异无统计学意义。基于多元逻辑回归分析,孕激素开始前的低血清LH水平被认为是与对活产的负面影响相关的最显著的预测因子(OR:0,421,95%CI0,178-0,994,p=0,048).雌激素起始日与孕激素给药前的血清LH水平和血清LH水平的四分位数显着相关(分别为r=0,200,p=0,015和r=0,215,p=0,009)。
■孕激素给药之前的血清LH水平显着影响接受FET人工子宫内膜准备方案的患者的妊娠率和活产率。LH监测应纳入后续行动,除了评估人工FET周期中的子宫内膜厚度和形态。
To evaluate the impact of serum LH levels prior to progestin administration on the outcomes of programmed frozen-thawed embryo transfer (FET) cycles.
Retrospective cohort study was conducted to compare the treatment outcomes between four groups based on the 25 percentiles of serum LH levels before progestin administration in 596 cycles of 518 patients undergoing artificial endometrial preparation protocols for FET. Primary outcome measures were ongoing and live birth rates. Secondary outcome measures were the pregnancy rates, clinical pregnancy rates, and pregnancy loss rates.
The trends in clinical pregnancy (CPR) and live birth rates (LBR) increased from the first to the fourth quartile (Q1 to Q4) of serum LH levels prior to progestin administration (37,0% to 48,3%, p = 0.042, and 22.6% to 39.5%, respectively, p = 0.003). Pregnancy loss rates (PLR) were higher in group Q1, although the difference was not statistically significant. Based on a multivariate logistic regression analysis, a low serum LH level before progestin initiation was found to be the most significant predictor associated with a negative effect on live birth (OR: 0,421, 95% CI 0,178 - 0,994, p=0,048). The day of estrogen initiation was significantly correlated with serum LH levels and quartiles of serum LH levels before progestin administration (r=0,200, p=0,015 and r=0,215, p=0,009, respectively).
The serum LH level prior to progestin administration significantly affects pregnancy and live birth rates in patients undergoing an artificial endometrial preparation protocol for FET. LH monitoring should be incorporated into the follow-up, in addition to assessing endometrial thickness and morphology in artificial FET cycles.