本文選題：再生育　切入點(diǎn)：繼發(fā)不孕　出處：《浙江大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：比較再生育繼發(fā)不孕婦女行體外受精一新鮮胚胎移植(IVF-ET)后,不同臨床妊娠結(jié)局的影響因素,評估各影響因素對臨床妊娠結(jié)局的相對重要性,為婦女再生育指導(dǎo)提供科學(xué)依據(jù)。 方法：回顧性分析2012年7月至2014年7月浙江大學(xué)醫(yī)學(xué)院附屬婦產(chǎn)科醫(yī)院因再生育繼發(fā)不孕行IVF-ET治療患者的臨床、實(shí)驗(yàn)室及隨訪資料。按是否臨床妊娠分為兩組,通過單因素分析和二元logistic回歸分析探究再生育繼發(fā)不孕婦女行IVF-ET臨床妊娠結(jié)局的影響因素。比較各年齡階段不同胚胎移植數(shù)的臨床妊娠結(jié)局以及GnRH-a長方案、GnRH-a短方案、GnRH-ant拮抗劑三種控制性超促排卵(COH)方案在≥40歲高齡再生育不孕患者中的助孕效果。 結(jié)果：來自1099位患者的1129例周期納入分析,376例(33.30%)臨床妊娠,753例(66.70%)未臨床妊娠,兩組患者的女方年齡、女方體重指數(shù)、基礎(chǔ)FSH、竇卵泡數(shù)目、男方年齡、移植胚胎數(shù)目等差異有統(tǒng)計學(xué)意義(均P0.05)。二元logistic回歸發(fā)現(xiàn)年齡(0R=0.900,95%CI：0.873-0.928,P0.001)、移植胚胎數(shù)目(OR=2.248,95%CI：1.906-2.652,P0.001)是再生育繼發(fā)不孕婦女IVF-ET臨床妊娠是否成功的獨(dú)立影響因素。30-40歲移植雙胚胎與30歲移植多胚胎的臨床妊娠率無顯著差異。年齡≥40歲應(yīng)用GnRH-a短方案、GnRH-a長方案或GnRH-ant方案,三者在臨床妊娠率水平無統(tǒng)計學(xué)差異(P0.05)。 結(jié)論：年齡和胚胎移植數(shù)目是預(yù)測再生育繼發(fā)不孕婦女IVF-ET臨床妊娠結(jié)局的獨(dú)立影響因素。30-40歲患者建議移植胚胎數(shù)不超過2個。年齡≥40歲再生育繼發(fā)不孕患者的臨床妊娠率顯著減低,應(yīng)用不同COH方案對其臨床妊娠率無顯著影響。
[Abstract]:Objective: to compare the influence factors of different clinical pregnancy outcomes after in vitro fertilization and fresh embryo transfer (IVF-ETT) in infertile women, and to evaluate the relative importance of these factors to the clinical pregnancy outcome. To provide the scientific basis for the guidance of women's rebirth. Methods: from July 2012 to July 2014, the clinical, laboratory and follow-up data of patients with secondary infertility treated by IVF-ET in the affiliated Obstetrics and Gynecology Hospital of Zhejiang University Medical College were analyzed retrospectively. Univariate analysis and binary logistic regression analysis were used to explore the influencing factors of IVF-ET pregnancy outcome in infertile women with secondary refertility. The clinical pregnancy outcome of different embryo transfer numbers at different age stages and the GnRH-a long term regimen GnRH-a short prescription were compared. The effect of GnRH-ant antagonist three kinds of controlled hyperstimulation for ovulation stimulation (COH) regimen in infertile patients aged more than 40 years. Results: a total of 1129 cases from 1099 patients were included in the analysis of 376 cases (33.30)) 753 cases of clinical pregnancy (66.70). The age of women, body mass index (BMI), basic FSHs, number of antral follicles, age of the male, age of the two groups were analyzed. There were significant differences in the number of embryos transferred (all P 0.05). The binary logistic regression analysis showed that the age of 0.900.00 and 95% CI0.873-0.928 and the number of transferred embryos were 2.24895 and 2.906-2.652p0.001, respectively. They were the independent influencing factors for the success of IVF-ET clinical pregnancy in women with secondary infertility. There was no significant difference in the clinical pregnancy rate of multiple embryos transferred over 40 years old. The short GnRH-a regimen or GnRH-ant regimen was used. There was no significant difference in clinical pregnancy rate among the three groups (P 0.05). Conclusion: age and number of embryo transfer are independent influencing factors for predicting clinical pregnancy outcome of IVF-ET in infertile women with secondary fertility. Patients aged 30-40 years should suggest that the number of embryos transferred should not be more than 2. The clinical pregnancy rate of. Different COH regimen had no significant effect on clinical pregnancy rate.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R714.8

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本文編號：1561476