单项β-人绒毛膜促性腺激素值对辅助生殖治疗妊娠成功的预测价值

The Predictive Value of Singleβ-Human Chorionic Gonadotropin Determination in Pregnancies Achieved by Assisted Reproductive Technology

目的:探讨单项血清β 人绒毛膜促性腺激素(β HCG)值在人类辅助生殖技术中预测妊娠结局的临床意义。 方法:对2000年11月至2004年8月本院所行的185个成功周期的体外受精与胚胎移植(IVF ET)进行回顾性分 析,185例患者均在胚胎移植后第14天抽血检测β HCG浓度,进行统计学分析。结果:185个成功周期继续妊娠 率为69.7%(129/185)。继续妊娠组与不良妊娠组β-HCG值分别为(731±442)IU/L、(113±133)IU/L,P< 0.01。以β HCG浓度200IU/L作为划分继续妊娠与不良妊娠的判断限值,敏感性为98%,特异性88%,其阳性预 测值为95%,阴性预测值为96%。在185例中有46例为多胎妊娠,其β HCG浓度为(1100±451)IU/L,显著高于 单胎妊娠β HCG值(504±244)IU/L,P<0.01。继续妊娠率随β HCG值的升高而增加,但多胎的概率也随之增 加。结论:辅助生殖技术中血清β HCG值是一项较好的早期预测妊娠结局的指标,多胎的预测更有助于医生及时 了解情况,采取必要的措施。

Objective: To investigate the clinical significance of the predictability value of serum β-human chorionic gonadotropin(β-HCG)in pregnancies achieved by assisted reproductive technology(ART).Methods:One hundred eighty five consecutive successful ART pregnancies between November 2000 and August 2004 were reviewed respectively.All subjects had a serumβ-HCG determination 14 days after ET.Results:One hundred twenty nine of the 185(69.7%) were found viable.The mean β-HCG value of nonviable was (113±133)IU/L, the viable was(731±442)IU/L,and statistically significant differences were found between these two groups,P<0.01.According to the cut off value of a single β-HCG >200 IU/L in distinguishing viable from nonviable pregnancies achieved, the sensitivity was 98%,specificity 88%,the positive predictive value 95%,the negative predictive value 96% 46 of 185 were multiple gestations.The meanβ-HCG value of the multiple gestations [(1100±451)IU/L] was significantly different from that of the single pregnancies[(504±224)IU/L].The probability of viable and furthermore multiple pregnancies increased when the value of β-HCG went up.Conclusion:A single serum β-HCG level at 14 days after ET is a useful predictor of pregnant outcome achieved by ART.It will help the gynecologists to take some measurements in timely.