体外受精新鲜胚胎移植术后14d血清β-hCG浓度与妊娠结局的关系

发布时间：2018-02-01 23:01

  本文关键词： 体外受精-胚胎移植(IVF-ET) 血清β-hCG 生化妊娠流产 异位妊娠 早期流产　出处：《生殖与避孕》2015年08期 　论文类型：期刊论文

【摘要】：目的:探讨体外受精-新鲜胚胎移植术后第14日后血清β-h CG浓度对临床妊娠结局的预测性。方法:对727例移植2枚第3日胚胎后第14日测血清β-h CG浓度7 IU/L的生化妊娠者追踪其临床结局,并回顾性分析正常宫内妊娠、异位妊娠、早期流产与血清β-h CG浓度的关系。结果:本组生化妊娠者,当其血清β-hC G在45 IU/L时,无正常宫内妊娠;46~100 IU/L时生化妊娠流产率为50.00%,正常宫内妊娠的发生率为25.00%,异位妊娠发生率为10.71%,早期流产率为14.29%。生化妊娠流产发生率随着血清β-h CG水平升高而下降,血清β-h CG200 IU/L发生率仅为4.17%。血清β-h CG400 IU/L者异位妊娠发生率(0.19%)与≤400 IU/L(10.20%)相比明显下降(P=0.007);当血清β-h CG500 IU/L时,早期流产率明显低于血清β-h CG500 IU/L(4.66%vs12.88%,P=0.002)。正常宫内妊娠血清β-h CG截断值为379.25 IU/L,ROC曲线下面积为0.868,95%CI=0.828~0.907。异位妊娠者中71.43%妇女存在输卵管性不孕因素,而早期流产者和生化妊娠流产者中存在男方因素性不孕分别占74.00%和68.75%。结论:胚胎移植后第14日血清β-h CG水平是有效预测妊娠的指标。当血清β-h CG≤45 IU/L时继续黄体支持治疗意义不大;血清β-h CG在46.00~379.25 IU/L范围内虽可继续黄体支持保胎,但要警惕异位妊娠及早期流产的发生,尤其是对有输卵管性不孕或男方因素性不孕的患者。
[Abstract]:Objective: to investigate the predictive effect of serum 尾 -hCG on clinical pregnancy outcome after in vitro fertilization and fresh embryo transfer. The clinical outcome of 727 cases of biochemical pregnancy whose serum 尾 -hCG concentration was measured for 7 IU/L on 14th after transplantation of 2 embryos on 3rd was followed up. The relationship between serum 尾 -hCG and normal intrauterine pregnancy, ectopic pregnancy, early abortion and serum 尾 -hCG concentration was analyzed retrospectively. No normal intrauterine pregnancy; The abortion rate of biochemical pregnancy, normal intrauterine pregnancy, ectopic pregnancy and ectopic pregnancy were 10.71% and 10.71%, respectively. The rate of early abortion was 14.29. The incidence of biochemical abortion decreased with the increase of serum 尾 -hCG level. The incidence of serum 尾 -h CG200 IU/L was only 4.17. The incidence of ectopic pregnancy in patients with serum 尾 -h CG400 IU/L was 0.19. 10.20) compared with the control group, the content of P0. 007 was significantly decreased. When serum 尾 -h CG500 IU/L, the rate of early abortion was significantly lower than that of serum 尾 -h CG500 IUR / L 4.66 vs 12.88%. The truncation value of serum 尾 -hCG in normal intrauterine pregnancy was 379.25 IUU / L ROC curve and the area under ROC curve was 0.868. 71.43% women with ectopic pregnancy had tubal infertility. Male factor infertility was found in 74.00% and 68. 75% of the patients with early abortion and biochemical pregnancy, respectively. Conclusion: serum 尾 -h was found in 14th after embryo transfer. CG level is an effective predictor of pregnancy. It is of little significance to continue luteal support therapy when serum 尾 -hCG 鈮，

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