激素替代冻融胚胎移植第6天血清孕酮与临床结局的关系

Relationship between Serum Progesterone Level on 6th Day and Clinical Outcome of FET with Hormone Replacement

目的:探讨在激素替代冻融胚胎移植(FET)周期中,移植第6天血清孕酮与FET临床结局的关系。方法:回顾性分析行激素替代FET 261个周期的临床资料。依据移植第6天血清孕酮水平分组,A组(孕酮<20μg/L),B组(20μg/L≤孕酮<30μg/L),C组(孕酮≥30μg/L),比较各组临床特征、妊娠率及流产率的差异。同时根据FET临床结局分为D组:宫内活胎组,E组:妊娠结局不良组,F组:未妊娠组,比较各组移植第6天血清雌激素、孕激素水平的差异。结果:C组妊娠率(50%)明显高于B组妊娠率(28.5%),B组妊娠率高于A组妊娠率(11.1%),差异有统计学意义(P<0.05);A组流产率(60%)高于C组(18%),差异有统计学意义(P<0.05);移植第6天血清孕酮水平D组和E组高于F组,差异有统计学意义(P<0.05)。结论:在激素替代FET周期中移植第6天血清孕酮水平对FET临床结局有一定的预测性,血清孕酮值越高妊娠结局越好,且流产率更低。

Objective： To explore the relationship between frozen embryo transfer （FET） clinical outcomes and serum level of progesterone on the sixth day in those FET cycles combined with hormone replacement. Methods： Those 261 FET cycles combined with hormone replacement were retrospectively analyzed. Those cycles were divided into three groups by serum level of progesterone （P） on the sixth day after FET. Serum level of progesterone was 〈20 μg/L in the group A, 20 μg/L≤P〈30 μg/L in the group B, and ≥30 μg/L in the group C. Clinical features, the pregnancy rate and abortion rate were analyzed. After that, those 261 cycles were divided into three groups by clinical outcomes of FET. The group D had intrauterine fetus, the group E had bad pregnancy outcomes, and the group F had not pregnancy. Then the serum levels of progesterone and estrogen on the sixth day after FET were compared. Results： The pregnancy rate of the group C （50%） was significantly higher than that of the group B （28.5%）, and the pregnancy rate of the group B was significantly higher than that of the group A （11.1%） （P〈0.05）. The abortion rate of the group A （60%） was significantly higher than that of the group C （18%） （P〈0.05）. The serum levels of progesterone on the sixth day after FET in the group D and the group E were significantly higher than that of the group F （P〈0.05）. Conclusions： The serum level of progesterone on the sixth day after FET combined with hormone replacement can be reasonably used as a marker to predict the clinical outcomes of FET. The higher level of progesterone could mean the better pregnancy outcomes, and the lower abortion rate.