冻融胚胎移植术后第9天血清β-HCG对单/双胎妊娠活产的预测价值

Study on the predictive value of beta - HCG levels on the 9th day after freeze - thaw embryotransplantation on live birth of single /twin pregnancy

目的探讨冻融胚胎移植(frozen-thawed embryo transfer,FET)术后第9天血清β-绒毛膜促性腺激素(beta-human chorionic gonadotropinβ-HCG)水平对单/双胎妊娠活产的临床预测价值。方法回顾性分析2012年12月—2019年3月在本院生殖中心FET并获得宫内妊娠的820例患者第9天(D9)血β-HCG值水平,根据妊娠结局的不同分为单胎活产组(A组)、单胎流产组(B组)、双胎活产组(C组)、双胎一胎流产组(D组)和双胎两胎流产组(E组),比较五组间基本特征。结合孕7周B超,分别对单胎妊娠和双胎妊娠患者进行分类树分析。结果(1)五组间在年龄、体质指数(Body Mass Index,BMI)、移植日子宫内膜厚度、不孕年限、不孕因素、受精方式的比较,差异无统计学意义(P>0.05);(2)五组间D9β-HCG值比较,差异有统计学意义(P<0.001);(3)FET后单胎妊娠患者D9β-HCG>79.40 IU/L,有99.0%几率单胎活产,D9β-HCG≤22.30 IU/L,则有76.90%几率单胎流产。双胎妊娠患者D9β-HCG>103.00 IU/L,有83.6%几率双胎活产,16.4%几率发生双胎其中一胎流产;D9β-HCG≤103.00 IU/L,则有28.8%几率发生双胎其中一胎流产,9.3%几率发生双胎流产。结论冻融胚胎移植术后第9天测定血清β-HCG水平对预测单/双胎妊娠活产有参考价值。

Objective To investigate value of serum beta-human chorionic gonadotropin(β-HCG)level on the 9th day after frozen-thawed embryo transfer(FET)on the prediction of live delivery of single/twin pregnancy.Methods A retrospective study was performed on a total of 820 cases patients adopted frozen-thawed embryo transfer and achieved uterine pregnancy at the reproductive center,Qingyuan people's hospital from December 2012 and March 2019.The data of serumβ-HCG levels on the 9th day after FET were record.According to the pregnancy outcome,patients were divided into single birth group(group A),single abortion group(group B),live twin birth group(group C),twin group with a case of abortion(group D)and twin abortion group(group E).The basic characteristics of the five groups were compared and classified tree analysis was conducted combined with ultrasound examination at 7th week of gestation.Results There were no statistically significant differences in age,BMI,intrauterine thickness at transplantation date,infertility years,infertility factors and fertilization methods among the five groups(P>0.05).The difference ofβ-HCG value on day 9 among the five groups was statistically significant(P<0.001).After FET,if D9β-HCG over 79.40 IU/L,the single pregnancy patients would have a 99.0%chance of single live birth,however,if D9β-HCG equal to or less than 22.30 IU/L they would have a 76.9%risk of single abortion.When D9β-HCG over 103.00 IU/L,the patients with twin pregnancy would have an 83.6%chance of twin live birth and 16.4%risk of single abortion.They would have a 28.8%risk of single abortion of the twins and 9.3%risk of twin abortion if the D9β-HCG equal to or less than 103.00 IU/L.Conclusions Determination of serumβ-HCG level on the 9th day after FET is valuable for the prediction of live birth of single/twin pregnancy.