摘要
目的探讨体外受精与胚胎移植助孕治疗的不孕症患者新鲜周期移植失败后冻融周期成功妊娠的相关影响因素。方法回顾性分析2012年1月至2014年4月在安徽医科大学第一附属医院生殖医学中心接受长方案超促排卵体外受精-胚胎移植（IVF-ET）助孕治疗的1165例不孕症患者的临床资料,包括新鲜周期妊娠组830个周期与新鲜周期未孕而冻融周期妊娠的335个周期,采用独立样本t检验和χ2检验对2组间相关临床参数进行比较,将筛选出差异有统计学意义的因素进行多因素Logistic回归检验。结果 Logistic回归分析发现,人绒毛膜促性腺激素（HCG）注射日雌二醇（E2）水平在50%~〈75%之间（OR=1.876,P=0.006,95%CI 1.199~2.935）及E2水平≥75%（OR=1.952,P=0.002,95%CI 1.276~2.985）和HCG注射日子宫内膜厚度（OR=0.882,P〈0.001,95%CI 0.824~0.944）是新鲜周期能否妊娠的独立影响因素。结论 HCG注射日血清E2水平上升明显和内膜厚度条件欠佳的患者,可建议放弃新鲜周期移植,采用冻融周期移植。
Objective To explore the factors affecting the outcome of frozen-thawed embryo transfers cycle after fresh embryo transfer failure.Methods A retrospective analysis was made including 1165 patients undergoing long GnRH-a protocol at the Reproductive Center of the First Affiliated Hospital of Anhui University. Study group included 830 pregnancy cycles and control group consisted of 335 cycles. Groups were compared using the independent-samples Student＇s t-test and Chi-Square tests. Multivariate logistic regression analysis was used to study the variables of statistically significant factors. Result In logistic regression analysis, serum E2 levels were between 50% and 75%（OR= 1.876, P=O.O06, with the 95% confidence interval 1.199-2.935）,E2 levels was more than 75% （OR=1.952, P=O.O02, with the 95% confidence interval 1.276-2.985）and endometrial thickness （OR=0.882, P〈O.O01, with the 95% confidence interval 0.824-0.944） on the day of HCG injection were found to be the independent predictor for frozen thawed embryo transfer （FET）pregnancy cycles in fresh cycles.Conclusions Elevated estradiol and thin endometrial thickness on the day of HCG injection have a potential negative effect. For these patients, FET should be suggested to improve the pregnancy outcome.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2015年第8期745-749,共5页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
体外受精-胚胎移植
雌激素
子宫内膜容受性
新鲜胚胎移植
冻融胚胎移植
in vitro fertilization-embryo transfer
estradiol
endometrial receptivity
fresh embryo transfers
frozen-thawed embryo transfers
