本文關鍵詞： 體外受精-胚胎移植(IVF-ET) 血清β-hCG 生化妊娠流產(chǎn) 異位妊娠 早期流產(chǎn)　出處：《生殖與避孕》2015年08期 　論文類型：期刊論文

【摘要】：目的:探討體外受精-新鮮胚胎移植術后第14日后血清β-h CG濃度對臨床妊娠結局的預測性。方法:對727例移植2枚第3日胚胎后第14日測血清β-h CG濃度7 IU/L的生化妊娠者追蹤其臨床結局,并回顧性分析正常宮內(nèi)妊娠、異位妊娠、早期流產(chǎn)與血清β-h CG濃度的關系。結果:本組生化妊娠者,當其血清β-hC G在45 IU/L時,無正常宮內(nèi)妊娠;46~100 IU/L時生化妊娠流產(chǎn)率為50.00%,正常宮內(nèi)妊娠的發(fā)生率為25.00%,異位妊娠發(fā)生率為10.71%,早期流產(chǎn)率為14.29%。生化妊娠流產(chǎn)發(fā)生率隨著血清β-h CG水平升高而下降,血清β-h CG200 IU/L發(fā)生率僅為4.17%。血清β-h CG400 IU/L者異位妊娠發(fā)生率(0.19%)與≤400 IU/L(10.20%)相比明顯下降(P=0.007);當血清β-h CG500 IU/L時,早期流產(chǎn)率明顯低于血清β-h CG500 IU/L(4.66%vs12.88%,P=0.002)。正常宮內(nèi)妊娠血清β-h CG截斷值為379.25 IU/L,ROC曲線下面積為0.868,95%CI=0.828~0.907。異位妊娠者中71.43%婦女存在輸卵管性不孕因素,而早期流產(chǎn)者和生化妊娠流產(chǎn)者中存在男方因素性不孕分別占74.00%和68.75%。結論:胚胎移植后第14日血清β-h CG水平是有效預測妊娠的指標。當血清β-h CG≤45 IU/L時繼續(xù)黃體支持治療意義不大;血清β-h CG在46.00~379.25 IU/L范圍內(nèi)雖可繼續(xù)黃體支持保胎,但要警惕異位妊娠及早期流產(chǎn)的發(fā)生,尤其是對有輸卵管性不孕或男方因素性不孕的患者。
[Abstract]:Objective: to investigate the predictive effect of serum 尾 -hCG on clinical pregnancy outcome after in vitro fertilization and fresh embryo transfer. The clinical outcome of 727 cases of biochemical pregnancy whose serum 尾 -hCG concentration was measured for 7 IU/L on 14th after transplantation of 2 embryos on 3rd was followed up. The relationship between serum 尾 -hCG and normal intrauterine pregnancy, ectopic pregnancy, early abortion and serum 尾 -hCG concentration was analyzed retrospectively. No normal intrauterine pregnancy; The abortion rate of biochemical pregnancy, normal intrauterine pregnancy, ectopic pregnancy and ectopic pregnancy were 10.71% and 10.71%, respectively. The rate of early abortion was 14.29. The incidence of biochemical abortion decreased with the increase of serum 尾 -hCG level. The incidence of serum 尾 -h CG200 IU/L was only 4.17. The incidence of ectopic pregnancy in patients with serum 尾 -h CG400 IU/L was 0.19. 10.20) compared with the control group, the content of P0. 007 was significantly decreased. When serum 尾 -h CG500 IU/L, the rate of early abortion was significantly lower than that of serum 尾 -h CG500 IUR / L 4.66 vs 12.88%. The truncation value of serum 尾 -hCG in normal intrauterine pregnancy was 379.25 IUU / L ROC curve and the area under ROC curve was 0.868. 71.43% women with ectopic pregnancy had tubal infertility. Male factor infertility was found in 74.00% and 68. 75% of the patients with early abortion and biochemical pregnancy, respectively. Conclusion: serum 尾 -h was found in 14th after embryo transfer. CG level is an effective predictor of pregnancy. It is of little significance to continue luteal support therapy when serum 尾 -hCG 鈮，

本文編號：1483075