影响体外受精-胚胎移植和胞质内精子注射后早期妊娠结局因素的探讨

study on the effects of early pregnancy outcome after in vitro fertilization-embryo transfer and intracytoplasmic sperm injection.

目的 :探讨影响体外受精 -胚胎移植 (IVF -ET)和胞质内精子注射 (ICSI)后早期妊娠结局的因素。方法 :测定IVF和ICSI胚胎移植 (ET) 2周后尿妊娠试验阳性 110例的当日血清绒毛膜促性腺激素 (hCG)值 ,于ET后 5周行B型超声检查 ,并对早期妊娠结局进行分析。结果 :早期妊娠 110例中 30例流产 ,除外 3例系减胎失败所致 ,流产率为2 5.2 % (2 7 10 7) ,其中IVF57例 ,流产 18例 ,除外 2例系减胎失败引起 ,流产率占 2 9.1%(16 55) ;ICSI53例 ,流产 12例 ,其中 1例因减胎流产 ,流产率占 2 1.2 % (11 52 ) ,两组流产率差异无显著性 (P >0 .0 5)。妊娠组与流产组的年龄和不孕时间差异有显著性 (P <0 .0 5) ,妊娠组血hCG值显著高于流产组者 (P <0 .0 1)。结论 :IVF—ET和ICSI后妊娠的早期流产率无明显区别 。

Objective:To study on the effects of early pregnancy outcome after in vitro fertilization-embryo transfer(IVF-ET)and intracytoplasmic sperm injection(ICSI).Methods:The serum hCG levels of 110 patients undergoing IVF and ICSI when positive pregnancy test was assayed after 2 weeks of embryo transfer.5 weeks later ,the B type sonography was performed.Results:In 110 cases of early pregnancy,there were 30 cases of abortion. The abortion rate was 25.2%(27/107),3 cases of embryo-reductive failure.In 57 cases by IVF,18 cases was aborted,including 2 cases induced by embry-reductive failure and the abortion rate was 29.1%(16/55);In 53 cases by ICSI there were 12 cases aborted,in which 1 case induced by embryo-reductive failure,and the abortion rate was 21.2%(11/52).Comparing the abortion rates of two groups,the difference was not significant(P>0.05).Of ages and sterility durations between pregnancy group and abortion group,the differences were significant(P<0.05).The level of blood hCG of pregnancy group was higher than that of the abortion group(P<0.01). Conclusions:The outcome of early pregnancy are associated with patients age,infertility duration and hCG value.No difference is found in early abortion rate between IVF group and ICSI group.