체외수정시술 프로그램에서 황체형성호르몬의억제와 임신율 사이의 상관 관계
The relationship between pregnancy rate and suppressionof luteinizing hormone in IVF-ET program
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목적: 체외 수정 시술 프로그램에서 후기 난포기의 황체형성호르몬의 과다 억제와 임신율 사이의 상관 관계를 알아보기 위하여 이번 연구를 시행하였다. 연구 방법: 1999년 1월부터 2002년 7월까지 고려대학교 산부인과학교실 불임클리닉에서 GnRH 효능제를 이용한 과배란 유도 실시 후 체외 수정 시술을 받았던 여성 350명 중 172 과배란유도주기를 연구 대상으로 하여, hCG 투여일의 황체형성호르몬 농도를 기준으로 황체형성호르몬 수치가 0.7 mIU/mL 이하인 군과 0.7 mIU/mL를 초과하는 군으로 나누어 두 군 간의 여러 지표들, 즉 환자의 나이, 불임의 원인, 기저의 난포자극호르몬, 황체형성호르몬, E2 농도 및 과배란 유도시 사용된 성선자극호르몬 용량과 그 사용기간, hCG 투여일의 E2, progesterone 농도, 그리고 회수된 난자수, 수정율, 분할율, 임신율 등을 후향적으로 비교 평가하였다. 결과: 과도 억제군과 경도 억제군의 임상적 특성, 기저 호르몬농도, 난자 회수의 수, 수정율 등은 두 군 간에 통계학적인 차이는 없었으나 과도 억제군의 임신율은 경도 억제군에 비하여 통계학적으로 의미있게 낮았다 (P=0.002). 결론: 과배란 유도시 황체형성호르몬의 과다 억제는 체외수정시술의 임신율 및 지속임신율에 좋지 않은 영향을 미치는 것으로 나타났다.
Abstract
Objective: To investigate the effect of profound LH suppression in the late follicular phase during controlled ovarian hyperstimulation (COH) on pregnancy rate. Methods: Data were collected by retrospective analysis. A total of 172 cycles of oocytes retrieval for IVF after COH with GnRH agonist-down regulation and hMG/FSH were included from January 1999 to July 2002. Serum LH, FSH, estradiol and progesterone concentrations were measured on the day 3 of the preceding cycle and LH concentration was measured on the day of hCG administration. Based on LH concentrations (mIU/mL) on the day of hCG administration, cycles are classfied to two groups (group 1: LH>0.7 mIU/mL, group 2: LH≤0.7 mIU/mL) and reproductive outcomes were compared between the two groups. Results: There were no significant differences between the two groups in the demographic characteristics, baseline hormone levels, number of eggs retrieved and fertilization rate. Pregnancy rate in the group 1 is higher than that of group 2. Conclusion: Patients with profound suppression of LH on the day of hCG administration were found to have worse reproductive outcome.
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