胚胎显微操作与妊娠早期人血清β-hCG值的关系

Relationship between Micromanipulation upon Gametes or Embryos and Serum β-hCG Level in Early Pregnancy

目的:探讨辅助生殖技术(ART)中的胚胎显微操作与妊娠早期血清β-hCG值的关系。方法:回顾性分析体外受精/卵胞质内单精子注射/胚胎植入前遗传学诊断(IVF/ICSI/PGD)新鲜囊胚移植的259个宫内妊娠周期,根据移植胚胎数及不同周期类型分组,比较移植14 d、18 d血清β-hCG水平的差异。结果:单囊胚移植组中,行IVF周期、ICSI周期和PGD周期间妊娠早期的血清β-hCG有统计学差异,其中常规移植14 d IVF周期血清β-hCG值为877.31±480.40 IU/L,显著高于ICSI周期711.86±485.64 IU/L,P<0.05。移植18 d时,两者血清β-hCG无统计学差异(4 198.32±2 306.48 IU/L vs 3 763.75±2 268.87 IU/L,P>0.05)。而PGD周期移植14 d血清β-hCG值为556.22±418.94 IU/L,18 d为3 027.22±2 455.80 IU/L,与IVF、ICSI周期相比均有显著统计学差异(P<0.05);双囊胚移植组中,IVF周期、ICSI周期及PGD周期各组间14 d、18 d血清β-hCG比较差异均无统计学意义(P>0.05)。结论:判断行ICSI、PGD周期患者妊娠与否时适度降低评估患者妊娠早期(移植14 d、18 d)有效妊娠血清β-hCG值标准是可行且必要的。

Objective： To investigate the relationship between micromanipulation in reproductive medicine and serum β-hCG level in early pregnancy. Methods： In this retrospective study, a total number of 820 patients who underwent fresh blastocyst transferred and obtained clinical pregnancy were analyzed. Serum β-hCG level and the rising range on day 14 and day 18 after blastocysts transfer were compared among the groups, which were divided according to the number of the blastocysts they transferred as well as the different assisted reproductive technology （ART） techniques they accepted. Results： In single blastocyst transfer group, patients undergoing intracytoplasmic sperm injection （ICSI） had a lower β-hCG level than those undergoing IVF and patients undergoing preimplantation genetic diagnosis （PGD） had a much lower level than that in IVF subgroup as well as ICSI subgroup. Both of the differences were statistical significant. While in two blastocysts transfer group although the patients＇ β-hCG level in ICSI and PGD subgroups were lower, there was no statistically significant difference. Conclusion： PGD may adversely affect serum β-hCG levels in early pregnancy. Setting a lower cut-off value for predicting a successful pregnancy in PGD could be helpful in counseling pregnant patients following PGD.