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目的通过监测冷冻胚胎解冻复苏移植(frozen embryos thawing recovery transfer,FET)前血清雌二醇(Estradiol E2)、孕酮(progesterone P)及内膜厚度,利用ROC曲线评价其预测妊娠结局的能力。方法回顾性分析2010年1月至2012年12月在内蒙古医科大学附属医院生殖中心行FET的临床资料,自然周期(组1)180例,激素替代周期(组2)187例,采用受试者工作特征曲线(ROC曲线)评估移植前日血清E2、P水平和内膜厚度对FET结局的预测价值,确定其临界值及最佳预测指标。结果比较两组血清E2和P及内膜的ROC曲线下面积与机会参考线下面积比较,对妊娠预测价值较低;而组1血清E2、P对流产的预测价值较高,ROC曲线下的面积分别为0.882和0.846,最佳临界值分别为204.4 pg/ml和18.15 ng/ml,均显著大于机会参考线下面积(P<0.05)。结论移植前血清E2、P值及内膜厚度不能有效评估FET妊娠,对妊娠预测价值较低,但自然周期E2、P值对FET的妊娠结局流产的预测价值较高,两者可作为预测FET结局流产的参考指标。
Objective To evaluate the predictive value of pregnancy outcome by monitoring the serum estradiol E2, progesterone P and intima thickness before freezing embryos thawing recovery transfer (FET). Methods The clinical data of FET in the Reproductive Center of Inner Mongolia Medical University Hospital from January 2010 to December 2012 were retrospectively analyzed. 180 cases of natural cycle (group 1) and 187 cases of hormone replacement cycle (group 2) The receiver operating characteristic curve (ROC curve) was used to assess the predictive value of E2, P level and intima thickness on FET outcome before the transplantation, and to determine the critical value and the best predictor. Results Compared with the area under the ROC curve, the areas under the curve of serum E2 and P and intima of the two groups showed lower predictive value for pregnancy. The predictive value of serum E2 and P in group 1 for abortion was higher than that under ROC curve Area of 0.882 and 0.846 respectively, the best cut-off value was 204.4 pg / ml and 18.15 ng / ml respectively, which were significantly higher than the area under the reference line of opportunity (P <0.05). Conclusions Pretreatment serum E2 and P values and intima thickness can not effectively evaluate FET pregnancy and have low predictive value for pregnancy. However, E2 and P values of natural cycles have a higher predictive value for predicting FET miscarriage, both of which can be used as prediction FET The outcome of abortion reference index.