ROC曲线评估FET移植前内膜厚度对妊娠结局的预测价值及临床分析

The predictive value of endometrial thickness before implantation for pregnancy outcome in frozen-thawed embryo transfer by ROC curve and clinical analysis

目的探讨移植前内膜厚度对冻融胚胎移植(FET)妊娠结局的预测价值。方法回顾性分析1261个FET周期的临床资料,利用ROC曲线分析移植前内膜厚度与妊娠结局的关系,计算内膜厚度的界值并进行分组,对各组的一般情况、临床资料及妊娠结局进行分析。结果根据ROC曲线计算其约登指数,得到内膜厚度的界值为9mm,根据这一内膜厚度将患者分为A组(≤9mm)和B组(>9mm),比较两组的一般情况,移植胚胎数、不孕因素、用药方案及临床妊娠率,年龄及临床妊娠率的差异有统计学意义(P<0.05)。进一步排除年龄因素的影响,在以内膜厚度分组的基础上按照年龄35岁分组比较妊娠率,在≤35岁组随着内膜厚度的增加妊娠率明显升高(P<0.05)。结论 FET周期中,移植前内膜厚度对妊娠结局有一定的预测价值,尤其对于≤35岁患者,尽可能的增加内膜厚度是提高临床妊娠率的有效方式。

Objective：To investigate the predictive value of preimplantation endometrial thickness on the outcome of frozenthawed embryo transfer（FET）. Methods：The clinical data of 1261 FET cycles were analyzed retrospectively. The relationship between endometrial thickness and pregnancy outcome was analyzed by ROC curve. The boundary value of endometrial thickness was calculated and the involved cases were grouped. The general condition,clinical data and pregnancy outcome of each group were analyzed. Results：According to the boundary value of endometrial thickness,the patients were divided into group A（≤9 mm）and group B（ 〉9 mm）.The number of transplanted embryos,infertility factors,medication regimen and clinical pregnancy rate,age and clinical pregnancy rate were statistically significant（P〈0.05）. To further rule out the influence of age factors,the pregnancy rate was compared with the age grouping group on the basis of grouping of endometrial thickness,and the pregnancy rate was significantly increased with the increase of endometrial thickness in the group of ≤35 years old（P〈0.05）. Conclusion：The endometrial thickness before implantation shows a certain predictive value for pregnancy outcome in FET. In particular,for patients with ≤35 years of age,increasing the endometrial thickness as much as possible is an effective way to improve the clinical pregnancy rate.