摘要
目的:分析新鲜胚胎移植后妊娠结局的影响因素,并探讨血清25-羟维生素D[25-hydroxyvitamin D,25(OH)D]、抗米勒氏管激素(anti-Müllerian hormone,AMH)水平对不孕症女性新鲜胚胎移植妊娠结局的预测价值。方法:回顾性分析2021年1月—2023年5月于东莞市松山湖中心医院行体外受精-胚胎移植(in vitro fertilization and embryotransfer,IVFET)/卵胞质内单精子注射-胚胎移植(intracytoplasmic sperm injection and embryo transfer,ICSI-ET)助孕的132例不孕症女性的临床资料,根据助孕后妊娠结局将其分为妊娠组(n=60)和未妊娠组(n=72)。收集并比较两组一般资料及血清25(OH)D、AMH水平等实验室检查结果,应用多因素logistic回归分析筛选出影响不孕症女性新鲜胚胎移植后妊娠结局的独立影响因素,绘制受试者工作特征(receiver operator characteristic,ROC)曲线分析血清25(OH)D、AMH水平单独及二者联合检测对不孕症女性胚胎移植妊娠结局的预测价值。结果:妊娠组促卵泡激素(follicle-stimulating hormone,FSH)/促黄体生成素(luteinising hormone,LH)≥1.8、获卵个数<8、窦卵泡个数<5的比例低于未妊娠组,血清25(OH)D及AMH水平高于未妊娠组,差异有统计学意义(P<0.05)。logistic回归分析结果显示:FSH/LH≥1.8、血清25(OH)D及AMH是不孕症女性IVT-ET妊娠失败的独立危险因素(P<0.05)。ROC曲线显示:血清25(OH)D、AMH及二者联合检测对妊娠失败的AUC分别为0.751、0.791及0.876,二者联合检测对妊娠失败的预测价值优于单独检测(P<0.05)。结论:血清25(OH)D、AMH水平低与不孕症女性新鲜胚胎移植妊娠失败有关,且二者联合检测进一步提高预测价值。
Objective:To explore the influencing factors of pregnancy outcome after fresh embryo transfer,and to explore the predictive value of serum 25-hydroxyvitamin D[25(OH)D]and anti-Müllerian hormone(AMH)levels on pregnancy outcome of fresh embryo transfer in infertile women.Method:The clinical data of 132 infertile women who underwent in vitro fertilization and embryotransfer(IVF-ET)/intracytoplasmic sperm injection and embryo transfer(ICSI-ET)assisted pregnancy in Dongguan Songshan Lake Central Hospital from January 2021 to May 2023 was retrospectively analyzed,they were divided into pregnancy group(n=60)and non-pregnancy group(n=72)according to the different pregnancy outcomes after assisted pregnancy.The general data and laboratory examination results such as serum 25(OH)D and AMH levels of two groups were collected and compared,multivariate logistic regression analysis was used to screen out the independent risk factors affecting the pregnancy outcome of infertility women after fresh embryo transfer.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum 25(OH)D and AMH levels alone and their combined detection on the pregnancy outcome of infertility women after embryo transfer.Result:The proportion of follicle-stimulating hormone(FSH)/luteinising hormone(LH)≥1.8,the proportion of retrieved oocytes<8 and the proportion of antral follicles<5 in the pregnancy group were significantly lower than those in the non-pregnancy group,and the serum 25(OH)D and AMH levels were significantly higher than those in the non-pregnancy group,the differences were statistically significant(P<0.05).logistic regression analysis showed that FSH/LH≥1.8,serum 25(OH)D and AMH were independent risk factors for IVT-ET pregnancy failure in infertility women(P<0.05).ROC curve showed that AUC of serum 25(OH)D,AMH and their combined detection for pregnancy failure were 0.751,0.791 and 0.876,respectively,the prediction of pregnancy failure by combined detection was better than those by single detection(P<0.05).Conclusion:Low levels of serum 25(OH)D and AMH are related to the failure of fresh embryo transfer in infertile women,and the combined detection of two is to further improve the predictive value.
作者
周丽玲
刘容菊
李光骁
何红梅
李青洋
蔡昭炜
王志鸣
ZHOU Liling;LIU Rongju;LI Guangxiao;HE Hongmei;LI Qingyang;CAI Zhaowei;WANG Zhiming(Dongguan Songshan Lake Central Hospital,Dongguan 523326,China;不详)
出处
《中外医学研究》
2024年第5期104-107,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
东莞市社会发展科技项目(20231800904042)
东莞市松山湖中心医院科研项目(SZR004)。
