黄体中期长方案助孕后早期流产相关因素分析

Analysis of the related factors of early abortion after long plan assisted pregnancy in mid luteal phase

目的分析体外受精/卵胞浆内单精子注射-胚胎移植治疗后发生早期流产的影响因素。方法回顾性分析2015年1月至2018年8月在首都医科大学附属北京妇产医院接受黄体中期长方案促排卵且获得临床妊娠患者的临床资料,共461例。根据妊娠结局将患者分为早期流产组(54例)和分娩组(407例)。比较两组患者的一般情况及促排卵结局,分析发生早期自然流产的相关因素。结果早期流产组与分娩组患者的年龄、孕前体质量指数、不孕类型、流产史、促甲状腺素、基础内分泌水平、窦卵泡数、注射绒毛膜促性腺激素日激素水平、获卵数比较差异均无统计学意义(P均>0.05);Logistic多因素回归分析显示,年龄与基础卵泡刺激素的增加是早期流产的危险因素。年龄≥35岁患者发生早期流产的风险是年龄<35岁患者的1.854倍,95%CI 1.027~3.347,P=0.041;基础卵泡刺激素≥10 U/L患者早期流产发生风险是基础卵泡刺激素<10 U/L患者的1.499倍,95%CI 0.776~2.895,P=0.048。结论年龄和基础卵泡刺激素是黄体中期长方案助孕妊娠后早期流产的危险因素。

Objective To analyze the influencing factors of early miscarriage after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer treatment.Methods From January 2015 to August 2018,461 cases of pregnant women who received mid luteal phase ovulation induction in Beijing Obstetrics and Gynecology Hospital,Capital Medical University were retrospectively analyzed.According to the pregnancy outcome,the patients were divided into early miscarriage group(54 cases)and delivery group(407 cases).The general situation and ovulation induction outcome of the two groups were compared,and the related factors of early spontaneous miscarriage were analyzed.Results There was no significant difference in age,pre pregnancy body mass index,type of infertility,history of abortion,thyrotropin,basal endocrine level,number of antral follicles,daily hormone level of hCG injection,and number of oocytes retrieved between early miscarriage group and delivery group(all P>0.05).Logistic regression analysis showed that age and basal follicle stimulating hormone were risk factors for early miscarriage.The risk of early miscarriage in patients with age≥35 years old was 1.854 times higher than that in patients younger than 35 years old,95%CI 1.027-3.347,P=0.041;the risk of early abortion in patients with basal FSH≥10 U/L was 1.499 times higher than that in patients with basal FSH<10 U/L,95%CI 0.776-2.895,P=0.048.Conclusion Age and basal follicle stimulating hormone are risk factors for early miscarriage after long protocol assisted pregnancy in mid luteal phase.