胚胎移植后10天血清E_2、P、β-HCG水平对不同移植周期妊娠结局的预测价值研究

The clinical predictive value of testing E_2,P,β-HCG level on the 10^(th) day after embryo transfer in different cycles

目的:探讨体外受精-胚胎移植(IVF-ET)后10d血清雌二醇(E_2)、孕酮(P)或β-人绒毛膜促性腺激素(β-HCG)水平对不同周期妊娠结局的预测价值。方法:回顾性分析于本院生殖中心行IVF-ET术376例患者,根据不同移植周期分为三组,A组197例,新鲜周期ET;B组97例,冻融胚胎移植(CET)自然周期准备内膜;C组82例,冻融胚胎移植(CET)非自然周期准备内膜。检测三组ET后10d E_2、P、β-HCG水平并应用ROC曲线回顾性分析。结果:(1)三组移植后10d E_2、P、β-HCG水平对临床妊娠均有预测价值,β-HCG的敏感性均高于E_2、P;(2)β-HCG水平的临界值,A组中明显低于其他两组,B组的明显高于其他两组。C组E_2临界值水平明显高于其他两组;(3)三组移植后10d E_2、P、β-HCG水平对流产和多胎妊娠的预测意义均不大,特异性和敏感性均较低。结论:胚胎移植术后10d血清E_2、P、β-HCG水平对不同移植周期临床妊娠结局均有良好的预测价值,其敏感性及临界值均不同,β-HCG具有更准确的诊断价值。

Objectives:To explore The clinical predictive value of testing E 2,P,β-HCG level on the 10 th day after embryo transfer in different cycles.Methods:The data of 376 patients receiving In vitro fertilization and embryo transplantation(IVF-ET)in the Center for Reproductive Medicine was analyzed and divided into 3 groups according to different embryo transfer(ET)cycles:group A with fresh ET(n=197),group B receiving CET with normal cycle(n=97)and group C receiving CET with non-nature cycle(n=82).By the area under ROC curve(AUC),the E2,P,β-HCG level on the 10 th day after ET was measured and the clinical pregnancy outcome of each group was analyzed.Results:(1)The E2,P,β-HCG level on the 10 th day after ET could predict the pregnancy outcomes in different HRT-ET cycles,and the sensitivity ofβ-HCG was higher than that of E2,P,etc.(2)The critical value ofβ-HCG levels in group A was significantly lower than the other two groups,the highest in group B.The critical value of E 2 in group C was significantly higher than the other two groups.(3)On the 10 th day after ET,the predictive value of E 2,P andβ-HCG levels on abortion and multiple pregnancy was not high,with low specificity and sensitivity.Conclusion:The E 2,P,β-HCG level on the 10 th day after embryo transfer can predict pregnancy outcomes in different HRT-ET cycles.