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新鲜胚胎移植周期发生生化妊娠的危险因素分析

Analysis of risk factors of biochemical pregnancy in fresh embryo transfer cycle
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摘要 目的探讨新鲜胚胎移植周期发生生化妊娠的相关危险因素。方法选取进行体外受精-胚胎移植(IVF-EF)或卵母细胞浆内单精子显微注射(ICSI-EF)后发生生化妊娠的207名患者作为研究组,同期获得单胎临床妊娠并活产的580名患者作为对照组。比较2组患者临床资料及助孕结局情况,选择差异有统计学意义的因素进行多因素logistic回归分析。结果研究组患者的人工流产次数、人工流产超过2次比例、伴卵巢储备功能减退、子宫内膜息肉及宫腔粘连的比例均高于对照组,基础睾酮水平(bT)低于对照组,差异有统计学意义(P<0.05);研究组采用长方案的比例、HCG日子宫内膜厚度及移植优质胚胎比例均低于对照组,采用无降调促排卵方案的比例高于对照组,差异有统计学意义(P<0.05);将HCG日子宫内膜厚度分组后,发现研究组HCG日子宫内膜厚度<8 mm比例高于对照组,HCG日子宫内膜厚度≥8 mm比例低于对照组(P<0.05)。以上因素纳入多因素Logistic回归分析后显示,bT水平、HCG日子宫内膜厚度及移植优质胚胎是生化妊娠的影响因素(P<0.05)。结论基础睾酮水平、HCG日子宫内膜厚度及移植优质胚胎为生化妊娠的保护性因素。 Objective To investigate the risk factors of biochemical pregnancy in fresh embryo transfer cycle.Methods 207 patients with biochemical pregnancy who received IVF/ICSI-ET assisted pregnancy treatment were selected as the study group,and 580 patients with clinical pregnancy and successful delivery were selected as the control group during the same period.The clinical data were collected for univariate and multivariate logistic regression analysis.Results The number of induced abortion,the proportion of induced abortion more than 2 times,the proportion of ovarian reserve with decreased function,endometrial polyps and uterine adhesions in the study group were higher than those in the control group,and the basal testosterone levels were lower than those in the control group,the differences were statistically significant(P<0.05).The proportion of long regimen,the thickness of endometrial membrane in HCG days and the proportion of high-quality embryo transfer in the study group were lower than those in the control group,and the proportion of ovulation induction regimen without descending tone was higher than that in the control group,the difference was statistically significant(P<0.05).After dividing the intrauterine membrane thickness on HCG days,it was found that the proportion of intrauterine membrane thickness<8 mm on HCG days in the study group was higher than that in the control group,and the proportion of intrauterine membrane thickness≥8 mm on HCG days was lower than that in the control group(P<0.05).Multivariate regression analysis showed that basal testosterone levels,endometrial thickness on HCG day,and transfer high quality embryosare significantly correlated with biochemical pregnancy(P<0.05).Conclusion Basal testosterone levels,endometrial thickness on HCG day and transfer high quality embryos are protective factors for biochemical pregnancy.
作者 杜玉冬 吴阳阳 屈潇潇 哈灵侠 DU Yudong;WU Yangyang;QU Xiaoxiao;HA Lingxia(Ningxia Medical University,Yinchuan 750004,China;Day Clinic,Cansu Provinal Maternity and child-care Hopsital;Center for reproductive Medicine,General Hospital of Ningxia Medical University,Yinchuan,75004,China;Key Laboratory of Fertility Preservation and Maintenance,Ministry of Education,Ningxia Medical University,Yinchuan,75004,China)
出处 《宁夏医学杂志》 CAS 2023年第2期136-139,共4页 Ningxia Medical Journal
基金 宁夏自然科学基金项目(2019A0209) 宁夏科技惠民项目(2022CMG03018)。
关键词 生化妊娠 体外受精-胚胎移植 子宫内膜容受性 胚胎质量 Biochemical pregnancy In vitro fertilization-embryo transfer Endometrial receptivity Embryo quality
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