拮抗剂方案双扳机次日血清β-hCG水平对新鲜胚胎移植结局的影响

Effect of Serumβ-hCG Level on the Next Day of Dual Trigger in Antagonist Regimen on the Outcome of Fresh Embryo Transfer

目的:探讨拮抗剂方案双扳机次日血清β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-hCG)水平对体外受精/卵胞质内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)新鲜胚胎移植周期妊娠结局的预测价值。方法:回顾性分析2017年1月-2024年1月于南京医科大学附属妇产医院生殖中心行拮抗剂方案促排卵患者共717个周期的临床资料,所有周期均采用双扳机(hCG+促性腺激素释放激素激动剂)诱导排卵,按照扳机次日血清β-hCG水平分为5组,A组(42个周期)β-hCG≤50 U/L,B组(282个周期)50 U/L<β-hCG≤100 U/L,C组(250个周期)100 U/L<β-hCG≤150 U/L,D组(92个周期)150 U/L<β-hCG≤200 U/L,E组(51个周期)β-hCG>200 U/L。比较各组的促排卵实验室结局及妊娠结局。结果:5组间体质量指数、基础卵泡刺激素、促性腺激素天数及总量、hCG日雌孕激素水平及高评分囊胚数的差异均有统计学意义(均P<0.05),其中体质量指数越高,扳机次日β-hCG水平越低。5组可利用胚胎数、高评分囊胚率、临床妊娠率、流产率及活产率比较,差异均无统计学意义(均P>0.05)。结论:在拮抗剂方案新鲜胚胎移植周期中,双扳机次日血清β-hCG水平并不能预测IVF/ICSI治疗周期的妊娠结局。

Objective:To explore the predictive value of the serumβ-human chorionic gonadotropin(β-hCG)level on the next day of dual trigger on the pregnancy outcome in fresh embryo transfer cycles of in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)in the antagonist regimen.Methods:A retrospective study was conducted on the clinical data of 717 cycles of patients who underwent antagonist therapy for ovulation induction at the reproductive center of the Women's Hospital of Nanjing Medical University from January 2017 to January 2024.All cases were induced to ovulate using a dual trigger method(hCG+gonadotropin-releasing hormone agonist).The patients were divided into 5 groups,based on the serumβ-hCG level on the day after the trigger:Group A(42 cycles)hadβ-hCG≤50 U/L,Group B(282 cycles)had 50 U/L<β-hCG≤100 U/L,Group C(250 cycles)had 100 U/L<β-hCG≤150 U/L,Group D(92 cycles)had 150 U/L<β-hCG≤200 U/L,and Group E(51 cycles)hadβ-hCG>200 U/L.The laboratory outcome of ovulation induction and pregnancy outcome among different groups were compared.Results:There were significant differences in body mass index(BMI),basal fllicle-stimulating hormone,days and total amount of gonadotropin,estrogen and progesterone levels on the trigger day,and the number of high-scoring blastocysts among the 5 groups(all P<0.05).As BMI increased,theβ-hCG level on the day after the trigger gradually decreased.There was no significant diference in the number of usable embryos,high scoring blastocyst rate,clinical pregnancy rate,miscarriage rate,and live birth rate among the 5 groups(all P>0.05).Conclusions:In the fresh embryo transfer cycle of the antagonist regimen,the serumβ-hCG level on the day after the dual trigger cannot predict the pregnancy outcome of the IVF/ICSI treatment.