取卵后立即冻胚移植患者血清E2、P、VEGF水平与妊娠结局的相关性

Association between serum E2,P and VEGF levels and pregnancy outcome of women intervened by frozen embryo transfer immediately after oocyte retrieval

目的比较取卵后立即行冻融胚胎移植患者三种内膜准备方案的妊娠结局,探讨血清E2、P、VEGF水平对妊娠结局的预测价值。方法选取2020年1~12月取卵后随即行冷冻胚胎移植的患者为研究对象174例,自然周期(A组)54例,激素替代周期(B组)64例,晚刺激周期(C组)56例,比较3组临床特征、妊娠结局,内膜转化前后检测血清E2、P、VEGF水平并比较分析。结果3组患者的临床妊娠率、着床率、异位妊娠率差异均无统计学意义(均P>0.05);B组的早期流产率高于C组(P=0.028);转化前血清E2水平及P水平3组间差异有统计学意义(均P<0.05),转化后HRT周期血清E2水平高于NC(P=0.001),血清VEGF水平在内膜转化前后差异均无统计学意义(P>0.05)。结论晚刺激周期与自然周期和激素替代周期妊娠结局相似,适合在取卵后立即行冻融胚胎移植的患者应用,血清E2、P、VEGF水平对妊娠结局不具有预测价值。

Objective To compare the pregnancy outcomes of three endometrial preparation programs in women intervened by frozen embryo transfer(FET)immediately after oocyte retrieval,and to explore the predictive value of serum estradiol(E2),progesterone(P)and vascular-endothelial growth factor(VEGF)levels on pregnancy outcomes.Methods A total of 174 women intervened by FET immediately after oocyte retrieval from January 2020 to December 2020 were retrospectively recruited,including 54 cases in natural cycle group(group A),64 cases in hormone replacement cycle group(group B)and 56 cases in late stimulation cycle group(Group C).The clinical characteristics and pregnancy outcomes of the three groups were compared.Serum levels of E2,P and VEGF were detected and analyzed before and after endometrial transformation.Results There were no significant differences in clinical pregnancy rate,implantation rate and ectopic pregnancy rate among the three groups(all P>0.05).The early abortion rate in group B was significantly higher than that in group C(P=0.028).There were significant difference in serum levels of E2 and P among the three groups before endometrial transformation(all P<0.05).The serum level of E2 in group B after endometrial transformation was significantly higher than that in group A(P=0.001).No significant difference was detected in serum level of VEGF before and after endometrial transformation(P>0.05).Conclusion The pregnancy outcome of late stimulation cycle is similar to that of natural cycle and hormone replacement cycle.It is suitable for application in women intervened by FET immediately after oocyte retrieval.Serum levels of E2,P and VEGF have no predictive value for pregnancy outcome.