冻融胚胎移植术后第9和11天β-HCG水平对单胎妊娠临床结局的预测价值

Predictive value of serum chorionic gonadotropin levels on the 9th and 11th day after freeze-thaw embryo transfer for single

目的探讨冻融胚胎移植术后第9和11天血清β-人绒毛膜促性腺激素(β-HCG)水平对单胎妊娠临床结局的预测价值。方法回顾性分析2012年12月-2018年8月于广州医科大学附属第六医院生殖中心行冻融胚胎移植术并获得单胎妊娠的342例患者的临床资料,按不同的妊娠结局将患者分为异位妊娠组、早期流产组和活产组,比较各组移植后第9和11天血清β-HCG的差异,绘制ROC曲线计算不同妊娠结局的β-HCG界值。结果各组移植后第9和11天β-HCG比较,差异有统计学意义(P<0.05),在冻融胚胎移植周期中,移植后第9天预测单胎宫内妊娠/异位妊娠和单胎活产/非活产的β-HCG最佳阈值分别为27.5和32.5 IU/L;移植后第11天预测单胎宫内妊娠/异位妊娠和单胎活产/非活产的β-HCG最佳阈值分别为77.5和119.0 IU/L。结论冻融胚胎移植术后第9和11天测定血清β-HCG水平能有效预测单胎异位妊娠、单胎早期流产及单胎活产等不同体外受精妊娠结局。

Objective To investigate serum beta-human chorionic gonadotropin(β-HCG)level on day 9 and day 11 as predictors for pregnancy outcome after frozen-thawed embryo transfer(FET)for single pregnancy during in vitro fertilization.Methods A retrospective study was performed in total 342 frozen-thawed embryo transfer cycles at the Center of Reproductive Medicine,the Sixth Affiliated Hospital of Guangzhou Medical Uniwersity between December 2012 and August 2018.The data of serumβ-HCG levels on day 9 and day 11 after FET cycles and the pregnancy outcomes were compared among ectopic pregnancy group(A),early abortion group(B)and live birth group(C),and the ROC curve was constructed to determine the optimal cut-off level of serumβ-HCG level for predicting pregnancy outcomes.Results Significant differences were found between the mean serumβ-HCG levels measured on day 9 and day 11 in all the 3 groups(P<0.05).The patients’β-HCG threshold value on day 9 that calculated by receiver operator characteristic curves were 27.50 IU/L for uterine and 32.50 IU/L for live birth.The threshold values on day 11 were 77.50 IU/L for uterine pregnancy and 119.00 IU/L for live birth.Conclusion The serumβ-HCG level on day 9 and day 11 after FET allows an accurate diagnosis of pregnancy and is helpful in the prediction of the pregnancy outcomes.