血清及卵泡液中25-羟维生素D水平与ART患者早期妊娠结局的关系

发布时间：2018-06-01 11:35

本文选题：体外受精-胚胎移植 + 冻融胚胎移植　；参考：《山西医科大学》2016年硕士论文

【摘要】：目的:探讨血清及卵泡液中25-羟维生素D[25(OH)D]水平与体外受精-胚胎移植(IVF-ET)及冻融胚胎移植(F-ET)患者早期妊娠结局的关系。方法:选取2014年9月至2015年5月在山西医科大学第一医院生殖科就诊,因输卵管因素不孕行IVF-ET助孕治疗的患者(123例)及冻融胚胎移植患者(108例),测定血清及卵泡液中25(OH)D水平,根据血清及卵泡液25(OH)D水平分为25nmol/L组、,25~50 nmol/L组和50 nmol/L组,分别比较各组间的胚胎种植率、临床妊娠率和早期流产率有无差异。又分别按照妊娠结局分为妊娠组和未妊娠组,比较两组间血清及卵泡液25(OH)D水平有无差异。结果:1.在体外受精-胚胎移植患者中,血清25(OH)D水平与卵泡液中25(OH)D水平呈显著正相关(r=0.811,P0.001);2.血清不同25(OH)D水平各组中,50 nmol/L组的胚胎种植率(53.3%)及临床妊娠率(73.3%)均显著高于25 nmol/L组(27.5%和28.0%)(P0.05);3.卵泡液不同25(OH)D水平各组中,25~50 nmol/L组及50 nmol/L组胚胎种植率(分别为42.3%、70.0%)及临床妊娠率(分别为66.7%、80.0%)均显著高于25 nmol/L组(21.4%和28.6%)(P均0.05)。各组间早期流产率比较无显著性差异(P0.05);4.妊娠组血清及卵泡液25(OH)D水平[分别为(38.41±13.58)nmol/L、(32.03±13.35)nmol/L]均显著高于未妊娠组[分别为(29.68±12.23)nmol/L、(23.41±11.54)nmol/L](P0.05);5.在冻融胚胎移植患者中,血清中50 nmol/L组的胚胎种植率显著高于25~50nmol/L组、25 nmol/L组(47.4%vs 14.5%,47.4%vs24.7%)。血清中50 nmol/L组的临床妊娠率显著高于25 nmol/L组及25~50 nmol/L组(85.7%vs32.3%,85.7%vs47.4%)。3组间的早期流产率比较差异无统计学意义(P0.05);6.妊娠组血清25(OH)D水平[(38.39±13.66)nmol/L]显著高于未妊娠组[(27.73±11.99)nmol/L](P0.05)。结论:不孕症患者普遍存在维生素D缺乏,ART患者的妊娠率下降可能与维生素D缺乏有关。
[Abstract]:Aim: to investigate the relationship between serum and follicular fluid 25 hydroxyvitamin D [25(OH)D] levels and early pregnancy outcomes in IVF-ETs and frozen-thawed embryo transfer (IVF-ETs) patients. Methods: from September 2014 to May 2015, 123 patients with infertility treated with IVF-ET for tubal infertility and 108 patients with frozen-thawed embryo transfer were selected from the Department of Reproduction, first Hospital of Shanxi Medical University. The levels of 25(OH)D in serum and follicular fluid were measured. The serum and follicular fluid 25(OH)D levels were compared between the two groups according to the outcome of pregnancy. The result is 1: 1. There was a significant positive correlation between serum 25(OH)D level and 25(OH)D level in follicular fluid in patients with in vitro fertilization and embryo transfer. The embryo implantation rate (53.3%) and clinical pregnancy rate (73.3%) of 50 nmol/L group were significantly higher than that of 25 nmol/L group (27.5%) and 28.0% (P 0.05%). The embryo implantation rate and clinical pregnancy rate of 2550 nmol/L group and 50 nmol/L group were significantly higher than that of 25 nmol/L group (21.4%) and 28.6% nmol/L group (80.0%). There was no significant difference in early abortion rate among groups. The levels of 25(OH)D in serum and follicular fluid in pregnancy group [38.41 卤13.58 nmol / L] were significantly higher than those in non-pregnant group [29.68 卤12.23 nmol / L, 23.41 卤11.54)nmol/L] (P 0.05). The clinical pregnancy rate of 50 nmol/L group was significantly higher than that of 25 nmol/L group and 2550 nmol/L group. There was no significant difference in the early abortion rate between the two groups. The serum 25(OH)D level in pregnancy group [38.39 卤13.66)nmol/L] was significantly higher than that in non-pregnant group [27.73 卤11.99)nmol/L] P 0.05. Conclusion: the decrease of pregnancy rate in infertility patients with vitamin D deficiency and art may be related to vitamin D deficiency.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R714.8

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