扳机后血清hCG浓度与获卵率及其他体外受精参数的相关性

Correlation between serum hCG level after triggering and oocytes retrieval rate and other IVF parameters

目的探讨取卵前血清人绒毛膜促性腺激素(hCG)浓度与获卵率及其他体外受精(IVF)参数的相关性.方法回顾性分析IV F中采用黄体中期促性腺激素释放激素激动剂长方案,存在卵巢过度刺激综合征风险的245例女性患者临床资料.根据患者取卵前血清hCG中位浓度分为A组(hCG<78.14 IU/L,122例)和B组(hCG≥78.14 IU/L,123例),比较两组间IVF结局参数.多重线性回归分析患者取卵前血清hCG浓度与获卵率的关系.绘制ROC曲线评价取卵前血清hCG浓度对获卵率的预测作用.结果与B组相比,A组患者BM I较高、扳机日卵泡数较多、hCG扳机剂量较低(P<0.05).A组获卵率低于B组[(88.27±25.61)%v s.(98.45±21.52)%](P<0.05).两组成熟卵子率、受精率、正常受精率、正常卵裂率、可用胚胎率和优质胚胎率均无统计学差异(P>0.05).多重线性回归分析结果显示,取卵前血清hCG浓度每增加10 IU/L,获卵率相应增加1.24%(P<0.05).取卵前血清hCG浓度预测获卵率≤66.67%的ROC曲线下面积为0.729[95%CI(0.644~0.813)],取卵前血清hCG浓度≤76.46 IU/L时,其预测患者获卵率≤66.67%的灵敏度为58.6%,特异度为80.0%.结论患者取卵前血清hCG浓度与获卵率呈正相关,取卵前血清hCG浓度预测获卵率是一个相对可靠的指标.

Objective To explore the relationship between serum Human chorionic gonadotropin(hCG) level before oocyte retrieval and oocyte retrieval rate and other in vitro fertilization(IVF) parameters.Methods The clinical data of 245 female at risk of ovarian hyperstimulation syndrome using a medium-luteal gonadotropin-releasing hormone agonist long protocol in IVF were retrospectively analyzed.According to the median concentration of serum hCG before oocyte retrieval, the patients were divided into two groups of A(hCG<78.14 IU/L,122 cases) and B(hCG≥78.14 IU/L,123 cases).The IVF outcome parameters between the two groups were compared.Multiple linear regression analysis was used to analyze the relationship between the concentration of serum hCG before oocyte retrieval and the oocyte retrieval rate.The ROC curve was drawn to evaluate the predictive effect of serum hCG concentration before oocyte retrieval on oocyte retrieval rate.Results Compared with group B,group A had higher BMI,more follicles on trigger day, and lower trigger dose of hCG(P<0.05).The oocyte retrieval rate of group A was lower than that of group B [(88.27±25.61)% vs.(98.45±21.52)%](P<0.05).There were no significant differences in the rate of mature eggs, fertilization rate, normal fertilization rate, normal cleavage rate, available embryo rate and high-quality embryo rate between the two groups(P>0.05).The results of multiple linear regression analysis showed that for every 10 IU/L increase in the concentration of serum hCG before oocyte retrieval, the oocyte retrieval rate increased by 1.24%(P<0.05).The area under the ROC curve of serum hCG concentration before oocyte retrieval to predict the oocyte retrieval rate ≤ 66.67% was 0.729 [95%CI(0.644-0.813)].When the concentration of serum hCG before oocyte retrieval was ≤ 76.46 IU/L,the sensitivity and specificity in predicting the oocyte retrieval rate of patients ≤66.67% were 58.6% and 80.0%,respectively.Conclusion The concentration of serum hCG before oocyte retrieval is positively correlated with the oocyte retrieval rate, which is a relatively reliable indicator to predict the oocyte retrieval rate.