论文部分内容阅读
目的探讨体外受精-胚胎移植后早期妊娠丢失的相关因素。方法回顾性分析体外受精获得妊娠1 720个周期的临床资料,按妊娠结局研究对象分为三组:A组(生化妊娠组)、B组(早期自然流产组)、C组(对照组)。C组为正常分娩或继续妊娠超过3个月者。分析3组患者基本情况、促排卵及体外受精过程对妊娠结局的影响。结果 B组年龄、基础促卵泡激素(basic follicle stimulating hormone,b FSH)水平、≥2次自然流产史高于A组和C组,差异有统计学意义(均有P<0.001);C组人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)注射后雌激素(estrogenic hormone,E2)水平下降率、卵泡晚期添加人绝经期促性腺激素(human menopausal gonadotropin,HMG)剂量及辅助孵化比例低于A组、B组,差异有统计学意义(均有P<0.05)。短方案组早期流产率高于长方案组,差异有统计学意义(P<0.05);子宫内膜异位症患者的早期流产率高于输卵管性不孕因素,差异有统计学意义(P<0.05)。多因素Logistic回归分析,年龄及≥2次自然流产史是早期自然流产的独立风险因素。结论高龄及≥2次自然流产史是体外受精早期自然流产的独立风险因素。
Objective To investigate the related factors of loss of early pregnancy after in vitro fertilization and embryo transfer. Methods The clinical data of 1 720 cycles of in vitro fertilization (IVF) were retrospectively analyzed. According to the outcome of pregnancy, the subjects were divided into three groups: group A (biochemical pregnancy group), group B (early spontaneous abortion group) and group C (control group). Group C was normal childbirth or pregnancy more than 3 months. Analysis of three groups of patients basic situation, ovulation and in vitro fertilization process on the outcome of pregnancy. Results The age of group B, the level of basic follicle stimulating hormone (b FSH) and spontaneous abortion ≥ 2 times were significantly higher than those of group A and C (all P <0.001) The declining rate of estrogenic hormone (E2) and the dosage of human menopausal gonadotropin (HMG) and the rate of auxiliary hatching during the late stage of follicular injection were lower than those of A Group B, the difference was statistically significant (both P <0.05). Short abortion group early abortion rate was higher than the long-term plan group, the difference was statistically significant (P <0.05); endometriosis early abortion rate was higher than tubal infertility factors, the difference was statistically significant (P < 0.05). Multivariate logistic regression analysis, age and history of ≥2 times of spontaneous abortion were independent risk factors of early spontaneous abortion. Conclusion The elderly and ≥2 spontaneous abortion history are independent risk factors of early spontaneous abortion after in vitro fertilization.