CAJ | 학술논문

体外受精-胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）过程中，在卵泡晚期人绒毛膜促性腺激素（hCG）注射日孕酮水平升高是否与妊娠结局有相关性，尚无统一的意见。针对这一问题，基于国内外的研究成果围绕hCG注射日孕酮水平升高对IVF结局的影响，首先阐明孕酮主要由卵泡颗粒细胞产生，而促排卵方案中多种因素可导致孕酮水平升高。其次从激素环境、卵母细胞的质量及子宫内膜的容受性方面综述了孕酮升高影响IVF结局的机制。然后，系统阐述了孕酮升高对IVF结局影响的实证研究，并进一步分析孕酮通过改变子宫内膜容受性而最终降低妊娠率。最后，在这些研究基础上，指导临床医生优化促排卵方案或移植方案，尽可能地改善实验室及临床结局，也为下一步研究微刺激/自然周期IVF提供理论依据。
체외수정-배태이식（in vitro fertilization-embryo transfer，IVF-ET）과정중，재란포만기인융모막촉성선격소（hCG）주사일잉동수평승고시부여임신결국유상관성，상무통일적의견。침대저일문제，기우국내외적연구성과위요hCG주사일잉동수평승고대IVF결국적영향，수선천명잉동주요유란포과립세포산생，이촉배란방안중다충인소가도치잉동수평승고。기차종격소배경、란모세포적질량급자궁내막적용수성방면종술료잉동승고영향IVF결국적궤제。연후，계통천술료잉동승고대IVF결국영향적실증연구，병진일보분석잉동통과개변자궁내막용수성이최종강저임신솔。최후，재저사연구기출상，지도림상의생우화촉배란방안혹이식방안，진가능지개선실험실급림상결국，야위하일보연구미자격/자연주기IVF제공이론의거。
There is a debate regarding the impact of the raised level of progesterone on the day of chorionic gonadotrophin (hCG) administration during late follicular phase on the outcomes of in vitro fertilization (IVF). Based on hypothesis that the raised level of progesterone on the day of hCG injection affect IVF outcome, it was found that progesterone was produced by follicular granulosa cells, and that a variety of factors increased the progesterone production during ovarian stimulation. The effects of the raised level of progesterone on IVF outcomes were reviewed, including hormone, oocyte quality and endometrial receptivity. We can conclude that the raised progesterone could reduce the pregnant rate by the lowered endometrial receptivity. This review will be helpful for doctors to optimize their protocols of ovarian stimulation and/or embryonic transplantation, so as to improve IVF outcomes and to explore new protocol of ovarian mini-stimulation/natural cycle.