| 叶希平,潘维君,黄存,等.冻融胚胎移植前血清雌、孕激素水平在体外受精 -胚胎移植治疗中对妊娠结局的影响[J].安徽医药,2021,25(2):336-341. |
| 冻融胚胎移植前血清雌、孕激素水平在体外受精 -胚胎移植治疗中对妊娠结局的影响 |
| Effects of serum estrogen and progesterone levels on pregnancy outcomes before frozen-thawed embryo transfer in vitro fertilization |
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| DOI：10.3969/j.issn.1009-6469.2021.02.030. |
| 中文关键词: 胚胎移植 体外受精 冷冻 雌二醇 孕酮 妊娠结局 危险因素 |
| 英文关键词: Embryo transfer Fertilization in vitro Freezing Estradiol Progesterone Pregnancy outcome Risk factor |
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| 中文摘要: |
| 目的探讨冻融胚胎移植前血清雌、孕激素水平在体外受精 -胚胎移植(IVF-ET)治疗中对妊娠结局的影响。方法回顾性分析 2017年8月至 2018年12月于马鞍山市妇幼保健院行 IVF-ET助孕治疗的病人 57例68个周期的临床资料，所有病人均接受冻融胚胎移植。记录所有病人的基线资料与妊娠结局并根据不同分组情况［移植前 1天雌二醇(Estradiol，E2)水平、移植前 1天孕酮(Progesterone，P)水平］并进行比较，行IVF-ET助孕病人临床妊娠的危险因素采用 logistic回归分析。结果根据移植前 1天 E2水平将所有病人分为 E2<150pg/mL组22例(27个周期)与E2 ≥ 150pg/mL组35例(41个周期)。E2<150pg/mL组病人移植前 1天 E2水平明显低于 E2 ≥ 150pg/mL组，种植率31.82%、临床妊娠率 37.04%均分别明显低于 E2 ≥ 150pg/mL组，且早期流产率 20.00%明显高于 E2 ≥ 150pg/mL组(均 P < 0.05)；两组其余基线资料比较均差异无统计学意义(均 P> 0.05)。根据移植前 1天 P水平将所有病人分为 P<18ng/mL组24例(30个周期)与P≥18ng/mL组33例(38个周期)。P<18ng/mL组病人移植前 1天 P水平明显低于 P ≥ 18ng/mL组，种植率 34.04%、临床妊娠率 36.67%均分别明显低于P ≥ 18ng/mL组，且早期流产率 18.18%明显高于 P≥18ng/mL组(均 P < 0.05)；两组其余基线资料之间比较均差异无统计学意义(均 P>0.05)。以行 IVF-ET助孕病人临床妊娠为因变量，对单因素分析中临床妊娠的可能危险因素进行 logistic回归分析，结果显示年龄、体质量指数、移植前 1天 E2、移植前 1天 P、移植日内膜厚度及稳态模型评估(HOMA)指数 HOMA-IR为行 IVF-ET助孕病人临床妊娠的独立危险因素(均 P < 0.05)。结论 IVF-ET治疗中冻融胚胎移植前 1天血清 E2、P水平可预测妊娠结局，且年龄、体质量指数、移植前 1天 E2和P、移植日内膜厚度及 HOMA指数 HOMA-IR均为行 IVF-ET助孕病人临床妊娠的独立危险因素。 |
| 英文摘要: |
| Objective To explore the effects of serum estrogen and progesterone levels on pregnancy outcomes before frozen-thawed embryo transfer in vitro fertilization (IVF-ET).Methods The clinical data of 57 patients with 68 cycles undergoing IVF-ET assisted pregnancy in Maternal and Child Health Care Center of Ma'anshan from August 2017 to December 2018 were retrospectively analyzed.All patients received frozen-thawed embryo transfer. The baseline data and pregnancy outcomes of all patients were recorded and compared according to different groups [estradiol (E2) level and progesterone (P) levels 1d before transplantation). The logistic regressionanalysis was used to analyze the risk factors of clinical pregnancy in IVF-ET assisted pregnancy patients.Results According to the level of E2 1d before transplantation, all patients were assigned into the E2 < 150 pg/mL group (n = 22, 27 cycles) and the E2 ≥ 150 pg/ mL group (n = 35, 41 cycles). The E2level of the E2 < 150 pg/mL group 1d before transplantation was significantly lower than that of the E2 ≥ 150 pg/mL group. The implantation rate (31.82%) and clinical pregnancy rate (37.04%) were significantly lower than those of the E2 ≥ 150 pg/mL group respectively, and the early abortion rate (20.00%) was significantly higher than that of the E2 ≥ 150 pg/mL group (all P< 0.05). There were no significant difference in the other baseline data between the two groups (all P> 0.05). According to the level of P 1d before transplantation, all patients were assigned into the P < 18 ng/mL group (n=24, 30 cycles) and the P ≥ 18 ng/mL group (n=33, 38 cycles). The P level of the P < 18 ng/mL group was significantly lower than that of the P ≥ 18 ng/mL group. The implantation rate (34.04%) and the clinical pregnancy rate (36.67%) were significantly lower than those of the P ≥ 18 ng/mL group, and theearly abortion rate (18.18%) was significantly higher than that of the P ≥ 18 ng/mL group (all P< 0.05). There were no significant differences in the other baseline data between the two groups (all P> 0.05). Regarding the clinical pregnancy of IVF-ET assisted pregnancypatients as dependent variable, logistic regression analysis was carried out on the possible risk factors for clinical pregnancy in univariate analysis. The results showed that age, body mass index, E2 level 1d before transplantation, P level 1d before transplantation, intimal thickness on transplantation day and homeostasis model assessment (HOMA) index HOMA-IR were the independent risk factors of clinical pregnancy in IVF-ET assisted pregnancy patients (all P< 0.05) .Conclusion The serum E2andP levels 1dbeforefrozen-thawed embryo transfer in IVF-ET treatment can predict pregnancy outcomes. Age, body mass index, E2 and P levels 1d before transplantation, intimal thickness on transplantation day and HOMA index HOMA-IR were independent risk factors of clinical pregnancy in IVF-ET assisted pregnancy patients. |
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