IVF-ET中自然流产的相关因素探讨

Factors of Spontaneous Abortion in IVF-ET

目的:探讨引起IVF-ET中自然流产的相关危险因素。方法:2004.01.01-2005.12.31间在本中心行IVF-ET获得妊娠的患者381例,排除异位妊娠28例,葡萄胎1例,运用单因素及多因素方法回顾性分析余下的352例患者年龄、病因、既往史、男方少弱精行单精子卵胞浆内显微注射史、月经d3基础激素水平、血PRL值、促排卵方案,以及取卵日的子宫内膜厚度,着床孕囊数等对流产的影响。结果:本研究期间本中心IVF-ET的流产率为13.1%。352例患者中年龄>35岁患者的流产率(32.3%)显著高于<35岁的患者(11.2%)(P<0.05),单孕囊的流产率(16.5%)显著高于双孕囊的流产率(5.6%)(P<0.05)。此外运用Logistic回归分析亦显示高泌乳素血症(OR=8.335)以及单孕囊(OR=3.550)与流产有显著相关性。单因素与多因素均提示既往病史(自然流产史,内异症等)、BMI值、月经d3的性激素(FSH、LH、E2、P)水平、促排卵方案、男方因素、受精方式(IVF/ICSI)以及取卵日子宫内膜厚度等均与流产无关。结论:IVF-ET的流产与患者的年龄、着床胚囊数以及高泌乳素血症有关。加强对治疗周期中高年龄、高泌乳素血症、单孕囊妊娠妇女的监控,积极治疗高泌乳素血症,尽可能采取保胎安胎措施,对防止IVF-ET妇女的自然流产具有极积的意义。

Objective： To invcstigate the rate and the correlation factors of early spontaneous abortion in IVF-ET. Methods： The pregnancy IVF-ET patients were calculated from 2004 to 2005. Then their age, abortion history, BMI, ICSI program, endocrine hormone on d 3, and hCG administration day, uterus size, thick of endometrium were analyzed. Results：The rate of spontaneous abortion in IVF^ET was 13.1%. The abortion rate （32.3%） of the patients who was older than 35 years old was significant higher than that （11.2%） of the patients who was younger than 35 years old （P〈0.05）.The patients who get single ernbryo implanted had a higher abortion rate （16.5%） compared with the patients who get double embryos implanted（5.6%） （P〈0.05）. Besides, the logistic recession showed that high level of PRL （OR=8.335） and single implanted embryo （OR=3.550） had a significant correlation with abortion. Conclusion： The age of the patients, the number of embryos implanted in uterus, and the PRL level are the factors Correlated with the abortion rate of IVF-ET.