The Predictive Value of Endometrial Thickness in the Suppression Status of E2, FSH and LH After Gonadotropin-releasing Hormone Analogue Administration

以子宮內膜厚度預測經性腺釋放激素抑制後人體血清之動情素、慮泡刺激素與黃體化 激素之抑制效果

謝耀元(Yao-Yuan Hsieh) ； 蔡鴻德(Horng-Der Tsai) ； 張其真(Chi-Chen Chang) ； 羅惠玉(Hui-Yu Lo)

《Mid-Taiwan Journal of Medicine》 5卷1期 (2000/03) Pp. 30-36

https://doi.org/10.6558/MTJM.2000.5(1).4

摘要

背景：本研究之目的在於決定子宮內膜厚度，用於預測經性腺釋放激素（gonadotropin-releasing hormone analogue，GnRHa）抑制後，人體血清之動情素（E2）、濾泡刺激素（FSH）與黃體化激素（LH）之抑制效果。方法：病患於進入超級卵巢刺激、體外受精與胚胎植入前，先經由GnRHa（1.875 g leuprolide acetate depot）來抑制腦下垂體與卵巢之分池。於月經週期之第二或第三天，偵測體內FSH ' LH ' E2之濃度，並以超音渡測量子宮內膜之厚，度。我們以E2濃度低於55 pg/ml，FSH濃度低於10 pg/ml或LH濃度低於10 pg/ml，定義為理想之腦下垂體抑制。進一步分析不同之子宮內膜厚度用於預測腦下垂體抑制狀況之敏感度、精確度、陽性預測值與陰性預測值。結果：本研究結果顯示5.5mm之子宮內膜厚度可當為一最佳之臨界值，用於評估腦下垂體與卵巢分泌之抑制狀況。以1.875g之leuprolide acetate depot可達到有效之腦下垂體抑制。結論：以55 mm之子宮內膜厚度可當為一最佳之臨界值，用於評估經GnRHa抑制後腦下垂體與卵巢分泌之抑制狀況。經由于宮內膜厚度之測量，FSH、LH及E2之常規性測量可選擇性地省略，以達到簡化人工生殖繁鎖步驟之目的。

關鍵字

子宮內膜厚度 ； 性腺釋放激素 ； 柳菩林 ； 超音波檢查

並列摘要

Background: The aim of this study was to determine the predictive values of endometrial thickness upon the suppression status of estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) after gonadotropin-releasing hormone analogue (GnRH-a) administrationMethods: Patients underwent in vitro fertilization-embryo transfer (IVF-ET) using GnRH-a;1.875 g leuprolide acetate depot) in a long protocol. The E2, FSH, LH and endometrial thickness were determined on day 2 or 3 of menstruation. We used E2 ＞55 pg/ml, FSH ＞ 10 pg/ml or LH ＞ 10 pg/ml to define pituitary suppression. The sensitivity, specificity, and positive and negative predictive values of different endometrial thickness in predicting the pituitary down-regulation were comparedResults: An endometrial thickness of 5.5 mm gave the most acceptable values of sensitivity and specificity in predicting the suppression of these hormones. Pituitary suppression was effectivel y achieved using 1.875 g of leuprolide acetate depot. Conclusions: An endometrial thickness of 5.5mm is the best cutoff value in predicting the pituitary suppression after a long protocol of GnRH-a administration. The llse of hormone surveys could be selectively omitted, which would simplify and increase the cost-effectiveness of assisted reproductive technology.

並列關鍵字

endometrial thickness ； gonadotropin-releasing hormone analogue ； leuprolide acetate depot ； sonography