影响体外受精胚胎移植妊娠结局的多因素分析

发布时间：2018-06-13 12:39

本文选题：体外受精胚胎移植 + 预测模型　；参考：《广东医学》2017年09期

【摘要】：目的探讨与体外受精胚胎移植妊娠成功率相关的临床因素,并在此基础上建立妊娠预测模型。方法选择950例新鲜胚胎移植周期接受体外受精或单精子卵胞浆内注射-胚胎移植(IVF/ICSI-ET)技术助孕治疗的患者,共计1 192个周期。去除取消移植的、数据丢失的、失访的和补救ICSI等情况的共242个周期,剩余950个周期纳入分析。按是否妊娠成功分为:成功组624例,妊娠成功;失败组326例,妊娠不成功。比较两组患者的年龄、病因、卵巢功能水平、促性腺激素(Gn)应用情况、人绒毛膜促性腺激素(HCG)日性激素水平、取卵情况以及胚胎相关情况等因素的差异。通过多因素logistic回归分析,对妊娠成功可能产生影响的8个特征性因素进行多因素分析。结果全组妊娠成功率为65.68%。与失败组相比,成功组的年龄、基础卵泡刺激素(FSH)、基础窦卵泡数、周期次数、Gn剂量、Gn时间、HCG日内膜厚度、HCG日黄体酮(P)水平、卵子数、受精率、优质胚胎数差异有统计学意义(P0.05)。多因素分析显示不孕症患者的年龄、HCG日P水平及优质胚胎数是移植妊娠成功的独立相关因素(P0.05)。结论 IVF/ICSI-ET治疗中影响妊娠成功率的临床因素是多方面的。
[Abstract]:Objective to investigate the clinical factors related to the success rate of in vitro fertilization and embryo transfer (IVF) and to establish a pregnancy prediction model. Methods 950 patients with IVF / ICSI-ETT in vitro fertilization or intracytoplasmic injection-embryo transfer (ICSI-ETT) were selected for 1 192 cycles. A total of 242 cycles of canceling transplantation, data loss, missing access and remediation ICSI were removed, and the remaining 950 cycles were included in the analysis. According to whether pregnancy was successful, 624 cases in successful group and 326 cases in failed group were divided into two groups: successful group (624 cases) and failed group (326 cases). The age, etiology, ovarian function, gonadotropin (Gn) application, daily HCG level, egg extraction and embryo related factors were compared between the two groups. By multivariate logistic regression analysis, 8 characteristic factors that may affect pregnancy success were analyzed. Results the success rate of pregnancy was 65.68%. Compared with the failed group, there were significant differences in age, basal follicle stimulating hormone (FSHN), basal antral follicle (FSH), number of basal antral follicles (FSH), number of cycles (G n), endometrial thickness of HCG day and progesterone (P) level, egg number, fertilization rate and number of high quality embryos in the successful group. Multivariate analysis showed that the age of infertile patients with HCG and the number of high quality embryos were independent factors related to the success of pregnancy transfer. Conclusion the clinical factors influencing pregnancy success rate in IVF-ICSI-ET therapy are various.
【作者单位】：珠海市妇幼保健院生殖中心;
【分类号】：R714.8

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