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目的:探讨IVF周期中采用不同促排卵方案时,卵泡液及血清中FSH、LH、E2水平的变化及对胚胎发育、受精、妊娠的影响;单用国产hMG促排卵的效果。方法:120例分成4组。测定卵泡液及取卵日血清中FSH、LH、E2水平,比较四种方案的取卵数、受精率、Ⅰ级、Ⅱ级胚胎形成率和每移植周期妊娠率。结果:四种促排卵方案的卵泡液和血清FSH、E2水平没有差别（P>0.05）,不同垂体降调节者,卵泡液和血清LH水平明显升高（P<0.0001）,四种促排卵方案的取卵数、受精率、优质胚胎形成率、移植周期妊娠率经统计学处理均无显著性差异。结论:卵泡液和血清中LH水平升高可能与应用垂体降调节有关,而与选择纯FSH还是hMG促排卵无关。轻度LH升高并不影响卵泡发育、卵子质量和以后的胚胎发育。IVF周期首选垂体降调节加FSH或FSH/hMG促排卵方案,单用hMG促排卵也可以作为选择。
OBJECTIVE: To investigate the changes of FSH, LH and E2 levels in follicular fluid and serum and the effects on embryo development, fertilization and pregnancy when IVF cycles are adopted in different ovulation induction programs. Methods: 120 cases were divided into 4 groups. The levels of FSH, LH and E2 in serum of follicular fluid and ovulation day were measured. The number of ovulation, fertilization rate, grade Ⅰ and Ⅱ embryo formation rate and pregnancy rate of each transplantation cycle were compared. Results: There was no difference in the levels of FSH and E2 in follicular fluid and serum between the four ovulation induction programs (P> 0.05). The levels of LH, follicular fluid and serum LH were significantly increased in different hypophysectomies (P <0.0001) The number of eggs, fertilization rate, the rate of high-quality embryo formation, pregnancy rate of the transplant cycle by the statistical analysis showed no significant difference. Conclusion: Elevated follicular fluid and serum LH levels may be related to the use of pituitary down regulation, but not with the selection of pure FSH or hMG ovulation has nothing to do. Mild LH elevation does not affect follicular development, egg quality and subsequent embryonic development. IVF cycle preferred hypothalamus plus FSH or FSH / hMG ovulation induction program, ovulation alone hMG can also be used as an option.