PCOS患者IVF-ET助孕结局及与血清E2、TPO-Ab、TG-Ab、AMH水平关系

Relationship between the pregnancy outcomes of women with PCOS after IVF-ET and their levels of serum estrogen, TPO-Ab, TG-Ab and AMH

目的:分析多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)助孕结局及与血清雌二醇(E2)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)、抗苗勒管激素(AMH)水平关系。方法:回顾性收集本院行IVF-ET助孕PCOS患者360例,依据使用人绒毛膜促性腺激素(HCG)日血清E2水平分为高、中、低E2组,依据TPO-Ab与TG-Ab检测结果分为甲状腺自身抗体(ATA)阳性组与阴性组,依据血清AMH水平分为高、中、低组,比较各组助孕结局。结果:E2中水平组受精率(81.7%)及临床妊娠率(56.9%)均高于另外两组(P<0.05),而另外两组无差异(P>0.05);ATA阳性组受精率(72.5%)低于ATA阴性组(79.7%),早期流产率(39.5%)高于ATA阴性组(17.2%)(P<0.05);移植胚胎数与优质胚胎数,低AMH组(1.43±0.20枚、3.07±0.60枚)<中AMH组(1.86±0.24枚、4.25±0.71枚)<高AMH组(2.45±0.25枚、7.52±1.02枚)(P<0.05)。结论:PCOS患者IVF-ET时,合理控制血清E2水平可增加患者受精率与临床妊娠率,ATA阳性可增加早期流产风险,高水平AMH患者可获得更好的移植胚胎及优质胚胎,为妊娠结局提供更佳条件。

Objective:To analyze relationship between the pregnancy outcomes of women with polycystic ovary syndrome(PCOS)after in vitro fertilization-embryo transfer(IVF-ET)and their levels of serum estrogen(E2),thyroid peroxidase antibody(TPO-Ab),thyroglobulin antibody(TG-Ab),and anti-Mullerian Hormone(AMH).Methods:The clinical data of 360 women with PCOS who underwent IVF-ET were analyzed retrospectively.According to different E2 level on the human chorionic gonadotropin(HCG)day,these women were divided into group A1(women with low E2 level),group A2(women with middle E2 level),and group A3(women with high E2 level).According to the detection results of TPO-Ab and TG-Ab,these women were divided into group B1(women with positive thyroid autoantibody)and group B2(women with negative thyroid autoantibody).And according to serum AMH level,these women were divided into group C1(women with high AMH level),group C2(women with middle AMH level),and group C3(women with low AMH level).The pregnancy outcomes were compared among these groups.Results:The fertilization rate and clinical pregnancy rate of women in group A2 were 81.7%and 56.9%,which were significant higher than those of women in group A1 and A3(P<0.05),but which had no significant different between group A1 and A3(P>0.05).The fertilization rate of women in group B1 was 72.5%,which was significant lower than that(79.7%)of women in group B2,but early abortion rate of women in group B1 was 39.5%,which was significant higher than that(17.2%)of women in group B2(P<0.05).The numbers of transplanted embryos and high-quality embryos of women in group C3 were 1.43±0.20 pieces and 3.07±0.60 pieces,which were significant less than those(1.86±0.24 pieces and 4.25±0.71 pieces)of women in group C2,and those(2.45±0.25 pieces and 7.52±1.02 pieces)of women in group C1 were the highest(P<0.05).Conclusion:Reasonable controlling serum E2 level of women with PCOS after IVF-ET can increase the fertilization rate and clinical pregnancy rate.The positive thyroid autoantibody of women with PCOS can increase their early abortion risk.The number of transplanted embryos and high-quality embryos of women with high AMH level is more,which can provide conditions for better pregnancy outcomes.