胚胎移植术后5、7、10天血清E_2、P、β-HCG检测对妊娠结局的预测价值研究

The predictive value of testing the level of E_2,P and β-HCG on the 5^(th),7^(th),and 10^(th) day after embryo transplantation on pregnancy outcomes

目的:探讨体外受精-胚胎移植(IVF-ET)后不同天数血清雌二醇(E_2)、孕酮(P)或β-人绒毛膜促性腺激素(β-HCG)水平对妊娠结局的预测价值。方法:收集枣庄市妇幼保健院生殖中心行IVF-ET的167例患者的临床资料,采用t检验或工作曲线(ROC)法进行回顾性分析妊娠结局与ET后5d、7d血清E_2、P及ET后10d血清β-HCG、P、E_2的关系。结果:(1)采用t检验比较临床妊娠组与未妊娠组ET后5d、7d血清E_2、P水平均无显著性差异(P>0.05),ET后10d血清β-HCG、P、E_2水平均有显著性差异(P<0.05)。(2)采用ROC曲线分析ET后10d血清E_2、P、β-HCG水平临床妊娠组与未妊娠组间比较,流产组与继续妊娠组间比较曲线下面积均大于0.5,血清β-HCG均大于血清E_2、P,且均大于0.8,具有诊断意义,临界值分别为160.50pg/m L、22.29ng/m L、17.69m IU/m L、394.0pg/m L、26.685ng/m L、97.10m IU/m L,单胎妊娠与多胎妊娠组间比较曲线下面积均小于0.5,无诊断意义。结论:ET后10d血清β-HCG、P、E_2水平可作为预测妊娠结局的指标之一,且血清β-HCG具有更明显的诊断价值。

Objectives：To explore the clinical predictive value of the level of E2,P and β-HCG on different days after in vitro fertilization-embryo transplantation（IVF-ET） on pregnancy outcomes.Methods：The clinical data of 167 patients received IVF-ET in Zaozhuang Maternal and Children Health Care Hospital was collected.T-test and ROC was employed to analyze the correlation between the pregnancy outcome and testing levels of E2,P on the postoperative 5th and 7thday and the levels of E2,P and β-HCG on the postoperative 10 thday.Results：（1） The level of E2 and P on the 5th and 7th day after embryo transfer between the pregnancy group and non-pregnancy group was not significantly different（P 〉 0.05）.The levels of E2,P and β-HCG on the 10 thday after embryo transfer significantly increased（P 〈 0.05）.（2） According to ROC curve analysis,the level of E2,P and β-HCG on the 10 thday after embryo transfer of clinical pregnancy group and non-pregnancy group,the area under the under the curve in clinical pregnancy group and continued pregnancy group were all greater than 0.5,and the level of β-HCG was greater than that of E2 and P,which was greater than 0.8.The critical values of diagnosis were 160.50pg/ml,22.29ng/ml,17.69 m IU/ml,394.0pg/ml,26.685ng/ml and 97.10 m IU/ml respectively.The area of single pregnancy and multiple pregnancies groups under the curve were both less than 0.5,indicating no diagnostic significance.Conclusion：The level of E2,P and β-HCG on the 10 thday after embryo transfer can predict pregnancy outcomes.