冻融胚胎移植周期中未破裂卵泡黄素化综合征发生的相关因素分析

Related factors of luteinized unruptured follicle syndrome in frozen-thawed embryo transfer cycle

目的 探讨冻融胚胎移植(FET)周期中未破裂卵泡黄素化综合征(LUFs)发生的相关因素。 方法 回顾性分析2015年1月至2018年5月在我院采用自然周期或者促排周期内膜准备方案的FET460例患者的临床资料,采用Logistic回归分析患者发生LUFs的相关风险因素。根据卵泡是否正常排卵,分为LUFs组(57例)和排卵组(403例)。结果 子宫内膜异位症[OR=9.509,95%CI(2.689,33.630)]及盆腔结核史[(OR=3.847,95%CI(1.705,8.682)为FET周期患者发生LUFs的主要相关因素;尿LH峰延迟[OR=1.167,95%CI(1.060,1.286)可以有效预测LUFs的发生,HCG诱导排卵[OR=5.889,95%CI(2.377,14.592)会促进LUFs的发生。 结论 子宫内膜异位症及盆腔结核史是发生LUFs的高危因素,尿LH峰延迟可能预测LUFs的发生,而HCG不能改善LUFs的结局,不适用于FET排卵方案。

Objective : To analyze the correlated factors of luteinized unruptured follicle syndrome(LUFs)in frozen-thawed embryo transfer cycle. Methods : The data of 460 patients who were treated with natural or stimulation protocol for endometrial preparation in frozen-thawed embryo transfer cycles in our hospital from January 2015 to May 2018.Logistic regression was used to analyze the risk factors of LUFs.According to whether the follicles ovulate normally,they were divided into LUFs group( n =57)and ovulation group( n =403). Results : Endometriosis [ OR =9.509,95% CI (2.689,33.630)] and history of pelvic tuberculosis [( OR =3.847,95% CI (1.705,8.682) were the main risk factors for LUFs in patients with FET cycle.The delayed surge of urinary LH can effectively predict the occurrence of LUFs [ OR =1.167,95% CI (1.060,1.286)].Ovulation induced by HCG may promote the incidence of LUFs [( OR =5.889,95% CI( 2.377,14.592)]. Conclusions : Endometriosis and history of pelvic tuberculosis are high risk factors for LUFs,and the delayed surge of urinary LH could be used as an effective predictor of LUFs.HCG cannot improve the outcome of LUFs and is not suitable for FET ovulation protocol.