摘要
目的探讨体外受精-胚胎移植(IVF-ET)周期中取卵(OPU)日至卵裂期胚胎移植(ET)日连续4 d血清雌二醇(E_(2))浓度变化对妊娠结局的预测价值。方法收集2017年1月至2021年6月在淄博市妇幼保健院生殖医学中心接受IVF-ET治疗的患者92例为研究对象,自OPU日至ET日连续4 d检测血清E_(2)浓度,分别记录为d_(0)E_(2)、d_(1)E_(2)、d_(2)E_(2)、d_(3)E_(2),根据妊娠结局不同分为妊娠组(n=44)和非妊娠组(n=48),比较两组患者的一般资料、E_(2)浓度、不同时间点血清E_(2)浓度变化率(d_(1-0)E_(2)%、d_(2-1)E_(2)%等)、获卵数及胚胎发育情况等,利用受试者工作特征(ROC)曲线评价d_(2-1)E_(2)%、d_(1)E_(2)对妊娠结局的预测价值。结果两组患者的一般资料无显著性差异(P>0.05)。OPU后两组的血清E_(2)浓度均表现出先下降后上升的趋势,妊娠组的d_(2)E_(2)和d_(2-1)E_(2)%显著高于非妊娠组(P<0.05),妊娠组的正常受精率显著高于非妊娠组(P<0.05)。d_(2-1)E_(2)%、d_(2)E_(2)及联合检测的ROC曲线下面积(AUC)分别为0.63、0.67和0.72(P<0.05),d_(2-1)E_(2)%和d_(2)E_(2)的最佳临界值分别为74.41%和4159.95 pmol/L,诊断敏感度分别为52.30%和65.90%,特异度分别为75.00%和64.60%;联合检测的敏感度为88.60%,特异度为56.20%。结论在IVF-ET周期中当d_(2-1)E_(2)%≥74.41%或d_(2)E_(2)≥4159.95 pmol/L时有预测妊娠结局的价值,联合检测的敏感度优于单一指标。
Objective:To explore the value of the change of serum estradiol(E_(2))concentration of 4 consecutive days from the day of ovum pick-up(OPU)to the day of embryo transfer(ET)during the IVF-ET cycle for predicting the pregnancy outcome.Methods:Ninety-two infertile patients received IVF-ET treatment in the Reproductive Medicine Center of Zibo Maternity and Child Health Hospital from January 2017 to June 2021 were collected as the research objects.Serum E_(2) levels were detected for 4 consecutive days from the OPU day to ET day,recorded as d_(0)E_(2),d_(1)E_(2),d_(2)E_(2) and d_(3)E_(2) respectively.According to different pregnancy outcomes,they were divided into pregnancy group(n=44)and non-pregnancy group(n=48).The general data,E_(2) concentration,the change rate of serum E_(2) concentration at different time points(d_(1-0)E_(2)%,d_(2-1)E_(2)%,etc.),number of oocytes retrieved and embryonic development of the two groups were compared.The receiver operating characteristic(ROC)curve was used to evaluate the significance of d_(2-1)E_(2)%and d_(1)E_(2) in predicting pregnancy outcome.Results:There was no significant difference in general data between pregnant group and non-pregnant group(P>0.05).After OPU,the serum concentration of E_(2) decreased first and then increased in the two groups.The d_(2)E_(2) and d_(2-1)E_(2)%in the pregnant group was significantly higher than that in the non-pregnant group(P<0.05),and the normal fertilization rate in the pregnant group was significantly higher than that in the non-pregnant group(P<0.05).The area under ROC curve(AUC)of d_(2-1)E_(2)%&d_(2)E_(2) and combined detection were 0.63,0.67 and 0.72 respectively.The optimum critical value of d_(2-1)E_(2)%&d_(2)E_(2) was 74.41%&4159.95 pmol/L respectively.The diagnostic sensitivity was 52.30%and 65.90%,and the specificity was 75.00%and 64.60%respectively.The sensitivity of combined detection is 88.60%and the specificity was 56.20%.Conclusions:In IVF-ET cycle,when d_(2-1)E_(2)%≥74.41%or d_(2)E_(2)≥4159.95 pmol/L,it has the value of predicting pregnancy outcome,and the sensitivity of combined detection is better than that of single indicator.
作者
孙玉琴
张睿
高磊
邹淑花
SUN Yu-qin;ZHANG Rui;GAO Lei;ZOU Shu-hua(Reproductive Medicine Center,Maternal&Child Health Hospital of Zibo City,Zibo 255029;Qingdao Women&Children’s Hospital Reproductive Center,Qingdao 266000;Reproductive Medicine Center,the International Peace Maternity&Child Health Hospital,Shanghai 200030)
出处
《生殖医学杂志》
CAS
2022年第3期302-308,共7页
Journal of Reproductive Medicine
基金
淄博市妇幼保健院发展基金(F201706)。
