摘要
目的:探讨新鲜胚胎移植后第14天血清β-HCG水平与妊娠及围产期结局相关性及其相关影响因素。方法:回顾分析2017年1月至2022年6月于郑州大学第三附属医院生殖中心行IVF/ICSI助孕并于新鲜周期移植胚胎患者的周期资料,根据移植后第14天血清β-HCG水平四分位数(P 25)不同将患者分为四组:A组、B组、C组及D组。比较各组患者的一般资料、妊娠及围产期结局,应用多因素logistic/线性回归分析影响活产率及胚胎移植后第14天血清β-HCG水平的相关因素。结果:4组患者的女方体质量指数(BMI)、HCG日内膜厚度及移植囊胚等级比较,差异有统计学意义(P均<0.05)。4组患者的妊娠期疾病(高血压疾病、妊娠期糖尿病、胎膜早破及前置胎盘)发生率、分娩孕周、新生儿出生体质量、低出生体质量儿率、巨大儿率、新生儿性别构成比及新生儿出生缺陷发生率比较,差异均无统计学意义(P均>0.05);A组的临床妊娠率及活产率明显低于B、C、D组,早期流产率显著高于B、C、D组,差异均有统计学意义(P均<0.001);D组的早产率显著低于A、C组(P=0.005)。移植后第14天血清β-HCG水平是活产率相关的独立预测因子(P<0.05)。多因素线性回归分析结果显示,女方BMI、HCG日内膜厚度及移植囊胚等级与血清β-HCG水平相关(P均<0.05)。结论:随着移植后第14天血清β-HCG水平升高,临床妊娠率和活产率先上升后趋于平稳,早期流产率呈先下降后平稳趋势;血清β-HCG水平与女方BMI、HCG日内膜厚度及移植囊胚等级相关。
Objective:To investigate the correlation between serumβ-HCG level at 14 days after fresh embryo transfer and pregnancy and perinatal outcomes and the related influencing factors.Methods:Cycle data of patients who underwent IVF/ICSI assisted pregnancy and fresh cycle embryo transplantation at Reproductive Medicine Center,the Third Affiliated Hospital of Zhengzhou University from January 2017 to June 2022 were retrospectively analyzed,and the patients were divided into four groups according to the different serumβ-HCG level quartile(P 25)on day 14 after transplantation:Groups A,B,C and D.General information,pregnancy and perinatal outcomes were compared in each group.Multivariate logistic/linear regression was used to analyze the related factors affecting the live birth rate and serumβ-HCG level at day 14 after embryo transfer.Results:There were differences in body mass index(BMI),daily intimal thickness of HCG and grade of transplanted blastula among the four groups(all P<0.05).There were no significant differences in the incidence of gestational diseases(hypertension,gestational diabetes,premature rupture of membrane and placenta previa),gestational weeks,birth weight of newborns,low birth weight rate,macrosomia rate,newborn sex ratio and neonatal birth defect rate among the four groups(all P>0.05).The clinical pregnancy rate and live birth rate of group A were significantly lower than those of group B,C and D(P<0.001).The rate of early abortion in group A was significantly higher than that in group B,C and D(P<0.001).The preterm birth rate of group D was lower than that of group A and C(P=0.005).Serumβ-HCG level at day 14 after transplantation was an independent predictor of live birth rate(P<0.05).The results of multivariate linear regression analysis showed that BMI,HCG daily intima thickness and transplanted blastocyst grade were correlated with serumβ-HCG level(all P<0.05).Conclusions:With the increase of serumβ-HCG level on the 14th day after transplantation,the clinical pregnancy rate and live birth first increased and then stabilized,while the early abortion rate first decreased and then stabilized.Serumβ-HCG level was correlated with BMI,daily intimal thickness of HCG and grade of transplanted blastula.
作者
刘永超
杨如雪
金帅
黄江笛
徐诗联
张贺博
Liu Yongchao;Yang Ruxue;Jin Shuai(Department of Obstetrics and Gynecology,Zhengzhou Chaoren Maternity Hospital,Zhengzhou 450052;Reproductive Center,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052)
出处
《现代妇产科进展》
北大核心
2023年第10期758-763,共6页
Progress in Obstetrics and Gynecology
关键词
鲜胚移植
Β-人绒毛膜促性腺激素
妊娠结局
围产期结局
Fresh embryo transplantation
β-human chorionic gonadotropin
Pregnancy outcome
Perinatal outcome
