en ارتباط بین سطح سرمی استرادیول در روز تجویز hCG و نتایج IVF-ICSI Original Article Original Article <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">مقدمه:</span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> استرادیول (</span></span><span dir="LTR"><span style="font-size:11.0pt;">E₂</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) جهت نمو فولیکول&shy;ها در تخمدان لازم </span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">بوده</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> و نقش مهمی در لانه&shy;گزینی جنین دارد.</span></span><span dir="LTR"><span style="font-size:11.0pt;"></span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">هدف:</span></span></strong> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">در این مطالعه، اثر سطح سرمی </span></span><span dir="LTR"><span style="font-size:11.0pt;">E₂</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در روز تجویز </span></span><span dir="LTR"><span style="font-size:11.0pt;">hCG</span></span><span style="font-size: 11pt;"><font face="b mitra"> در بیماران کاندید </font><span style="color:#000000;">IVF-ICSI</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">&nbsp;که تحت تحریک کنترل شده تخمدان قرار گرفته بودند، بررسی گردید.</span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">مواد و روش&shy;ها:</span></span></strong> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">تعداد 203 زن که یک بار تحت درمان </span></span><span dir="LTR"><span style="font-size:11.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> قرار گرفته بودند در این مطالعه بررسی شدند. تمام بیماران، تحت درمان با پروتکل طولانی یا پروتکل </span></span><span dir="LTR"><span style="font-size:11.0pt;">Microdose flare</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> بودند. بیماران بر اساس سطح سرمی </span></span><span dir="LTR"><span style="font-size:11.0pt;">E₂</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در دوز تجویز </span></span><span dir="LTR"><span style="font-size:11.0pt;">hCG</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در 5 گروه طبقه&shy;بندی گردیدند. </span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتایج: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">در 203 بیمار، متوسط تعداد اووسیت&shy;های بدست آمده 6/7</span></span><span style="font-size:11.0pt;">&plusmn;</span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">10/6، متوسط درصد باروری،</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">24/8</span></span><span style="font-size:11.0pt;">&plusmn;</span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">55/7 و متوسط درصد لانه &shy;گزینی 19/2</span></span><span style="font-size:11.0pt;">&plusmn;</span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">9 بود و در نهایت 43 بیمار (21%) حامله شدند. در مقایسه نتایج کلی، تعداد اووسیت &shy;های بدست آمده و تعداد امبریوهای منتقل شده در بیماران با سطح سرمی </span></span><span dir="LTR"><span style="font-size:11.0pt;">E₂</span></span>&nbsp; pg/ml<span style="font-family:b mitra;"><span style="font-size:11.0pt;">&nbsp;4000</span></span><span style="font-family:calibri,sans-serif;"><span style="font-size:11.0pt;">></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">، بهتر بود و این اختلاف معنی&shy; دار گزارش گردید. این اختلاف در بیماران بالای 37 سال معنی&shy;دار نبود. همچنین در خانم&shy;های زیر 36 سال نتایج </span></span><font face="b mitra" style="font-size: 14.6667px;">&nbsp;</font><span style="font-size: 14.6667px; color: rgb(0, 0, 0);">IVF-ICSI</span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">&nbsp;در بیماران با سطح سرمی&nbsp; </span></span><span dir="LTR"><span style="font-size:11.0pt;">pg/ml</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> 4000</span></span><span style="font-family:calibri,sans-serif;"><span style="font-size:11.0pt;">></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">، بهتر بود. </span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتیجه&shy; گیری: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">علیرغم اینکه شواهد قوی مبنی بر ارتباط مثبت سطح سرمی </span></span><span dir="LTR"><span style="font-size:11.0pt;">E₂</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> و نتایج </span></span><span dir="LTR"><span style="font-size:11.0pt;">IVF-ICSI</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در دسترس نبوده، نتایج این مطالعه نشان می&shy;دهند که سطح بالای سرمی </span></span><span dir="LTR"><span style="font-size:11.0pt;">E₂</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در حین تحریک تخمک&shy;گذاری ممکن است در ارتباط با افزایش حاملگی باشد که این موضوع در ارتباط با پاسخ بهتر تخمدان است. در مقایسه نتایج کلی، بهترین نتایج در بیماران با سطح سرمی بیش از </span></span><span dir="LTR"><span style="font-size:11.0pt;">pg/ml</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> 4000 بدست آمد. </span></span> <strong>Background:</strong> Estradiol (E2) is required for follicular development and play an important role in embryo implantation.<br> <strong>Objective: </strong>The aim of this study was to assess the impact of serum E2 levels on the day of hCG administration in IVF-ICSI patients who are performed controlled ovarian hyperstimulation (COH).<br> <strong>Materials and Methods:</strong> A total of 203 women who were undergone one time IVF cyclus were evaluated in this cross sectional study. All the patients were treated either with long protocol or with microdose flare protocol. The patients were categorized into five groups according to the serum E2 levels on the day of hCG administration.<br> <strong>Results: </strong>The mean number of the retrieved oocytes was (NRO) 10.6&plusmn;6.7, mean fertilization rate was 55.7&plusmn;24.8, and implantation rate was 9.0&plusmn;19.2. Of 203 patients, 43 (21%) patients were pregnant. When the overall results are examined, the number of the retrieved oocytes and the number of transferred embryos were better in patients with serum E2 levels >4000 pg/ml and these values were statistically significant. There were no statistical difference in patients 37 years or older. In women ?36 years old, the IVF-ICSI outcomes were better in patients with serum E2 levels >4000 pg/ml.<br> <strong>Conclusion:</strong> In spite of the lack of high quality evidence to support a positive association between serum E2 levels and IVF-ICSI outcomes, this study shows that high E2 levels during COH might be associated with an increased potential of pregnancy depending on better ovarian response. When the overall results are examined, the best scores were in patients with serum E2 levels >4000 pg/ml. IVF, استرادیول, حاملگی, FSH In-vitro fertilization, Estradiol, Pregnancy, Follicle stimulating hormone. 53 58 http://ijrm.ir/browse.php?a_code=A-10-31-28&slc_lang=en&sid=1 Mustafa Kara mustafa.kara@bozok.edu.tr Yes Department of Obstetrics and Gynecology, Medical Faculty, Bozok University, Yozgat, Turkey Tayfun Kutlu No Zeynep Kamil Women's and Children's Hospital, Reproductive Medicine and IVF Unit, Istanbul, Turkey Kenan Sofuoglu No Zeynep Kamil Women's and Children's Hospital, Reproductive Medicine and IVF Unit, Istanbul, Turkey Belgin Devranoglu No Zeynep Kamil Women's and Children's Hospital, Reproductive Medicine and IVF Unit, Istanbul, Turkey Tansel Cetinkaya No Zeynep Kamil Women's and Children's Hospital, Reproductive Medicine and IVF Unit, Istanbul, Turkey