血清雌二醇、25(OH)维生素D水平与冻融单囊胚移植临床结局关系

Correlation between serum estradiol and 25(OH)D levels of the women and the clinical outcomes after single frozen-thawed blastocyst transfer

目的:探究血清雌二醇(E2)、25-OH维生素D[25(OH)D]水平与冻融单囊胚移植(SFBT)临床妊娠结局的相关性。方法:回顾性分析2018年6月-2020年7月于本院接受SFBT的204例女性临床资料,依据临床妊娠结局分为妊娠组(107例)和非妊娠组(97例)。比较两组一般资料;微颗粒化学发光法测定血清E2水平,高效液相色谱-串联质谱仪测定血清25(OH)D水平;logistic回归分析影响临床妊娠结局的因素;使用受试者工作特征(ROC)曲线预测血清E2、25(OH)D水平对临床妊娠结局的预测价值。结果:两组年龄、不孕年限、体质指数、子宫内膜厚度、不孕类型、基础卵泡刺激素(bFSH)水平无差异(P>0.05);妊娠组血清E2(544.92±108.63 pmol/L)、25(OH)D(65.37±16.26 nmol/L)水平均高于非妊娠组(365.73±72.57 pmol/L、41.65±10.44 nmol/L)(P<0.05);E2、25(OH)D是影响临床妊娠结局的保护因素(P<0.05),年龄是影响临床妊娠结局的危险因素(P<0.05);血清E2、25(OH)D预测SFBT临床妊娠结局的曲线下面积(AUC)分别为0.892、0.893,截断值分别为444.76 pmol/L、52.72 nmol/L,敏感度分别为89.7%、88.7%,特异性分别为79.4%、78.5%;两者联合预测SFBT临床妊娠结局的AUC 0.949,敏感度87.6%,特异性93.5%。结论SFBT非妊娠女性血清E2、25(OH)D水平较低,两者均可能影响SFBT临床妊娠结局,联合检测对SFBT临床妊娠结局有预测价值。

Objective:To explore the correlation between serum estradiol(E2),25-OH vitamin D[25(OH)D]levels of the women and their clinical pregnancy outcome after single frozen-thawed blastocyst transfer(SFBT).Methods:The clinical data of 204 women who had received SFBT from June 2018 to July 2020 were analyzed retrospectively,and according to the clinical pregnancy outcomes,these women were divided into group A(107 women with clinical pregnancy)and group B(97 women without clinical pregnancy).The general data of the women were compared between the two groups.The level of serum E2 of the women was measured by microparticle chemiluminescence method,and the level of serum 25(OH)D of the women was determined by high performance liquid chromatography-tandem mass spectrometry.Logistic regression analysis was used to analyze the influencing factors of clinical pregnancy outcomes,and receiver operating characteristic(ROC)curve was used to analyze the predicting value of serum E2 and 25(OH)D levels for clinical pregnancy outcomes.Results:There were no significant differences in age,duration of infertility,body mass index,endometrial thickness,infertility type,and basal follicle stimulating hormone(bFSH)level of the women between the two groups(P>0.05).The levels of serum E2(544.92±108.63 pmol/L)and 25(OH)D(65.37±16.26 nmol/L)of the women in group A were significant higher than those(365.73±72.57 pmol/L and 41.65±10.44 nmol/L)of the women in group B(P<0.05).The levels of serum E2 and 25(OH)D of the women were the protective factors affecting their clinical pregnancy outcomes(P<0.05),but age of the women was the risk factor affecting their clinical pregnancy outcomes(P<0.05).The area under the curve(AUC),the cutoff value,the sensitivity,and the specificity of the E2 level for predicting the clinical pregnancy outcomes of the women after SFBT were 0.892,444.76 pmol/L,89.7%,and 79.4%.The AUC,the cutoff value,the sensitivity,and the specificity of the 25(OH)D level for predicting the clinical pregnancy outcomes of the women after SFBT were 0.893,52.72 nmol/L,88.7%,and 78.5%,respectively.And the AUC,the sensitivity,and the specificity of combinational E2 and 25(OH)D levels for predicting the clinical pregnancy outcomes of the women after SFBT were 0.949,87.6%,and 93.5%,respectively.Conclusion:The levels of serum E2 and 25(OH)D of the women without pregnancy after SFBT are low,which may affect the clinical pregnancy outcomes of the women after SFBT.The combination of the detected levels of E2 and 25(OH)D of the women after SFBT can improve the predictive value for clinical pregnancy outcomes.