胚胎移植术14～16天后单次血HCG值与多胎,胎儿性别和临床流产之关系

The relationship between the single level of serum human chorionic gonadotropin(HCG) at 14～15th day after embryo transfer and the multiple-pregnancy,the gender of fetal,the clinic abortion

目的探讨在胚胎移植(ET)后第14～16天单次血HCG值与临床妊娠最终结局的关系。方法 329例常规超促排取卵移植后第14～16天检测血HCG值确定生化妊娠,于移植后35天腹部B超确定临床妊娠,追踪随访直至妊娠的最终结局。在329例临床妊娠中,有145例在移植后第14天测血HCG值;102例在移植后第15天测血HCG值;82例移植后第16天测血HCG值。并按照检测血HCG的时间,将随访的妊娠结局分为四组。多胎(包括双胎和三胎)组,单胎女婴组,单胎男婴组,临床流产组(包括早、中、晚期流产),One-Way ANOVA检验分析移植血HCG水平与多胎,胎儿性别,临床妊娠流产的关系。结果 1.在移植第14-16天,血HCG水平在多胎组、单胎女婴组、单胎男婴组、临床流产组均逐渐降低,多胎组血HCG水平与单胎女婴组、单胎男婴组、临床流产组之间均存在统计学差异。2.在145例移植后第14天,单胎女婴组与单胎男婴组(P=0.037)、临床流产组之间(P=0.001)均存在统计学差异,单胎男婴组与临床流产组间未见明显统计学差异(P=0.202)。3.在移植第15及第16天,单胎女婴组与单胎男婴组未见明显统计学差异(P=0.204及P=0.379),与临床流产组间有统计学差异(P=0.009及P=0.001);而单胎男婴组与临床流产组无统计学差异(P=0.154及P=0.083)。结论胚胎移植后第14-16天血HCG值与临床妊娠最终结局有密切相关性。多胎妊娠组,单胎女性组,单胎男婴组,临床流产组的血HCG均值逐渐降低。多胎妊娠显著高于单胎组;临床流产组显著低于单胎女性组。单胎男婴组与临床流产组无统计学差异。

Objective：To determine the relationship between serum human chorionic gonadotrop（HCG） at 14 days-16 days after embryo transfer and pregnancy outcome in long run.Methods：The pregnancy outcomes of 329 cases whose gestational sacs were detected and the serum HCG levels of 14 days-16 days after fresh cycle IVF/ ICSI-ET were retrospectively analyzed.Among 329 cases,there were 145 case detected the serum HCG level at the 14th day after embryo transfer,102 cases detected the serum HCG level at the 15th day after embryo transfer and 82 cases at the 16th day after embryo transfer.According to the day of detecting serum HCG.We divided the 329 cases into four groups by their outcomes：multiple pregnancy,singleton female infant,singleton male infant,clinical abortion.And according the day of detecting serum HCG we compared their levels of serum HCG after embryo transfer using One-Way ANOVA test.Results：1.The levels of serum HCG went down according to multiple pregnancies,singleton female infants,singleton male infants,clinical abortions.There was the significant difference between multiple pregnancies and other groups.2.At the 14th day after embryo-transfer,there was the significant difference of the serum HCG levels between singleton female infants and singleton male infants,clinical abortions but there was no significant difference between singleton male infants and clinical abortions.3.At 15th and 16th day after embryo-transfer,there was the significant difference of the serum HCG levels between singleton female infants and clinical abortions but no significant difference between singleton male infants and clinical abortions.There was also no significant difference between singleton female infants and singleton male infants.Conclusion：1.The levels of serum HCG at the 14-16th day after embryo-transfer were correlated with their pregnancy outcome.The mean levels of serum HCG step down according multiple pregnancy,singleton female infant,singleton male infant,clinical abortion;The serum HCG mean level of multiple-pregnancy group is significantly higher than that of other groups.The serum HCG mean level of singleton female infant group is significantly higher than that of clinical abortion group while The serum HCG mean level of singleton male infant group is not significantly higher than that of clinical abortion one.