影响再生育继发不孕妇女IVF-ET临床妊娠结局的因素分析

发布时间：2018-03-03 14:44

本文选题：再生育　切入点：继发不孕　出处：《浙江大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：比较再生育继发不孕妇女行体外受精一新鲜胚胎移植(IVF-ET)后,不同临床妊娠结局的影响因素,评估各影响因素对临床妊娠结局的相对重要性,为妇女再生育指导提供科学依据。方法：回顾性分析2012年7月至2014年7月浙江大学医学院附属妇产科医院因再生育继发不孕行IVF-ET治疗患者的临床、实验室及随访资料。按是否临床妊娠分为两组,通过单因素分析和二元logistic回归分析探究再生育继发不孕妇女行IVF-ET临床妊娠结局的影响因素。比较各年龄阶段不同胚胎移植数的临床妊娠结局以及GnRH-a长方案、GnRH-a短方案、GnRH-ant拮抗剂三种控制性超促排卵(COH)方案在≥40岁高龄再生育不孕患者中的助孕效果。结果：来自1099位患者的1129例周期纳入分析,376例(33.30%)临床妊娠,753例(66.70%)未临床妊娠,两组患者的女方年龄、女方体重指数、基础FSH、窦卵泡数目、男方年龄、移植胚胎数目等差异有统计学意义(均P0.05)。二元logistic回归发现年龄(0R=0.900,95%CI：0.873-0.928,P0.001)、移植胚胎数目(OR=2.248,95%CI：1.906-2.652,P0.001)是再生育继发不孕妇女IVF-ET临床妊娠是否成功的独立影响因素。30-40岁移植双胚胎与30岁移植多胚胎的临床妊娠率无显著差异。年龄≥40岁应用GnRH-a短方案、GnRH-a长方案或GnRH-ant方案,三者在临床妊娠率水平无统计学差异(P0.05)。结论：年龄和胚胎移植数目是预测再生育继发不孕妇女IVF-ET临床妊娠结局的独立影响因素。30-40岁患者建议移植胚胎数不超过2个。年龄≥40岁再生育继发不孕患者的临床妊娠率显著减低,应用不同COH方案对其临床妊娠率无显著影响。
[Abstract]:Objective: to compare the influence factors of different clinical pregnancy outcomes after in vitro fertilization and fresh embryo transfer (IVF-ETT) in infertile women, and to evaluate the relative importance of these factors to the clinical pregnancy outcome. To provide the scientific basis for the guidance of women's rebirth. Methods: from July 2012 to July 2014, the clinical, laboratory and follow-up data of patients with secondary infertility treated by IVF-ET in the affiliated Obstetrics and Gynecology Hospital of Zhejiang University Medical College were analyzed retrospectively. Univariate analysis and binary logistic regression analysis were used to explore the influencing factors of IVF-ET pregnancy outcome in infertile women with secondary refertility. The clinical pregnancy outcome of different embryo transfer numbers at different age stages and the GnRH-a long term regimen GnRH-a short prescription were compared. The effect of GnRH-ant antagonist three kinds of controlled hyperstimulation for ovulation stimulation (COH) regimen in infertile patients aged more than 40 years. Results: a total of 1129 cases from 1099 patients were included in the analysis of 376 cases (33.30)) 753 cases of clinical pregnancy (66.70). The age of women, body mass index (BMI), basic FSHs, number of antral follicles, age of the male, age of the two groups were analyzed. There were significant differences in the number of embryos transferred (all P 0.05). The binary logistic regression analysis showed that the age of 0.900.00 and 95% CI0.873-0.928 and the number of transferred embryos were 2.24895 and 2.906-2.652p0.001, respectively. They were the independent influencing factors for the success of IVF-ET clinical pregnancy in women with secondary infertility. There was no significant difference in the clinical pregnancy rate of multiple embryos transferred over 40 years old. The short GnRH-a regimen or GnRH-ant regimen was used. There was no significant difference in clinical pregnancy rate among the three groups (P 0.05). Conclusion: age and number of embryo transfer are independent influencing factors for predicting clinical pregnancy outcome of IVF-ET in infertile women with secondary fertility. Patients aged 30-40 years should suggest that the number of embryos transferred should not be more than 2. The clinical pregnancy rate of. Different COH regimen had no significant effect on clinical pregnancy rate.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R714.8

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