血清胰岛素样生长因子-1、D-二聚体水平与不孕症患者体外受精-胚胎移植妊娠丢失的关系

Relationship between serum IGF-1,D-D levels and pregnancy loss after IVF-ET in patients with infertility

目的检测不孕症患者血清胰岛素样生长因子-1(IGF-1)、D-二聚体(D-D)水平,并分析二者与不孕症患者体外受精-胚胎移植(IVF-ET)妊娠丢失的关系。方法选取2019年4月至2021年4月唐山市妇幼保健院收治的1045例不孕症患者作为研究对象。全部患者均接受IVF-ET并随访至妊娠结束,依据患者妊娠结局将患者分为丢失组(n=156)与未丢失组(n=889)。比较两组基线资料、实验室指标,并分析IVF-ET前血清IGF-1、D-D水平与不孕症患者IVF-ET妊娠丢失的关系。结果1045例不孕症患者的妊娠丢失率为14.93%(156/1045)。丢失组孕前体重指数、IVF-ET前血清睾酮(T)、D-D水平高于未丢失组,孕酮(P)、IGF-1水平低于未丢失组(P<0.05)。Logistic回归分析结果显示,孕前体重指数高和IVF-ET前血清T、D-D水平高是不孕症患者IVF-ET妊娠丢失的危险因素(OR>1,P<0.05),IVF-ET前血清P、IGF-1水平高是其保护因素(OR<1,P<0.05)。结论不孕症患者IVF-ET妊娠丢失可能与IVF-ET前血清IGF-1、D-D水平有关。

Objective To detect the levels of serum insulin-like growth factor-1(IGF-1)and D-dimer(D-D)in patients with infertility,and to analyze the relationship between them and pregnancy loss after in vitro fertilization and embryo transfer(IVF-ET)in patients with infertility.Methods 1,045 patients with infertility treated in Tangshan Maternal and Child Health Hospital from April 2019 to April 2021 were selected as the research subjects,all patients received IVF-ET and were followed up until the end of pregnancy;according to the pregnancy outcome,the patients were divided into loss group and non-loss group.The baseline data and laboratory indexes of the two groups were compared,the relationship between serum IGF-1 and D-D levels before IVF-ET and pregnancy loss after IVF-ET in patients with infertility was analyzed.Results There were 156 cases of pregnancy loss after IVF-ET in 1,045 in patients with infertility,and the pregnancy loss rate was 14.93%(156/1,045);the pre-pregnancy body mass index,serum testosterone(T)and D-D levels before IVF-ET in loss group were higher than those in the non-loss group,and the levels of progesterone(P)and IGF-1 were lower than those in the non-loss group(P<0.05).Logistic regression analysis showed that,high pre-pregnancy body mass index,high serum T and D-D before IVF-ET were the risk factors of pregnancy loss after IVF-ET(OR>1,P<0.05),and high serum P and IGF-1 before IVF-ET were the protective factors(OR<1,P<0.05).Conclusions Pregnancy loss after IVF-ET in patients with infertility may be related to the levels of serum IGF-1 and D-D before IVF-ET.