冻融胚胎移植日血清激素水平与结局的相关性

Relationship between serum hormone levels and outcome in infertile patients on the day of frozen-thawed embryo transfer

目的研究不孕症患者在冻融胚胎移植(frozen-thawed embryo transfer,FET)当日雌二醇(estradiol,E2)、孕酮(progesterone,P)水平,E2/P与周期结局的相关性。方法选择2016年4月至2020年1月于皖南医学院弋矶山医院生殖医学中心行人工周期(Hormone replacement cycle,HRT)备内膜的492个解冻移植周期进行回顾性分析,根据移植后4周B超是否见孕囊分为临床妊娠组和未孕组,比较两组临床特征、移植当天E2/P、E2水平、P水平;根据妊娠组周期结局分为活产组和流产组,比较两组临床特征、移植当天E2水平、P水平;根据所有周期E2/P值、E2、P值百分位数各分为四个亚组(0%~25%,26%~50%,51%~75%,76%~100%),比较各组临床特征、胚胎种植率,临床妊娠率,流产率。结果临床妊娠组患者年龄明显低于未孕组,差异有统计学意义(P<0.05);E2水平、E2/P值各组间周期结局之间差异无统计学意义(P>0.05);P水平在13.30 ng/mL~17.5 ng/mL时胚胎种植率、临床妊娠率较其他各组明显降低,差异有统计学意义(P<0.05)。结论结论激素替代周期移植患者年龄与周期结局显著相关;E2水平、E2/P值可能与周期结局相关;P水平与FET周期结局呈显著相关。

To investigate the correlation between the levels of estradiol(E2),progesterone(P),E2/P and cycle outcome of infertile patients on the day of frozen-thawed embryo transfer(FET).Methods From April 2016 to January 2020,492 thawing transplantation cycles of the Hormone replacement cycle(HRT)prepared in the Reproduction Medicine Center of Yijishan Hospital,Wannan Medical University were retrospectively analyzed.The patients were divided into clinical pregnant group and non-pregnant group according to whether pregnancy cyst was found in B-mode ultrasound 4 weeks after transplantation.Clinical characteristics,E2/P,E2 and P levels were compared between the two groups on the day of transplantation.The pregnancy group was divided into live birth group and abortion group according to the cycle outcome.The clinical characteristics,E2 level and P level of the two groups were compared on the day of transplantation.Four subgroups(0%~25%,26%~50%,51%~75%,and 76%~100%)were divided according to E2/P values,E2 and P percentiles of all cycles.The clinical characteristics,embryo implantation rate,clinical pregnancy rate,and abortion rate of each group were compared.Results The age of the pregnant group was significantly lower than that of the non-pregnant group,the difference was statistically significant(P<0.05).When P level was 13.30 ng/mL~17.5 ng/mL,embryo implantation rate and clinical pregnancy rate were significantly lower than those in other groups,with statistical significance(P<0.05).Conclusion The level of E2 and E2/P on the day of transplantation may be related to the outcome of FET cycle.P levels were significantly correlated with the cycle outcome of FET.