本文選題：體外受精-胚胎移植 + 凍融胚胎移植�。� 參考：《山西醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:探討血清及卵泡液中25-羥維生素D[25(OH)D]水平與體外受精-胚胎移植(IVF-ET)及凍融胚胎移植(F-ET)患者早期妊娠結(jié)局的關(guān)系。方法:選取2014年9月至2015年5月在山西醫(yī)科大學(xué)第一醫(yī)院生殖科就診,因輸卵管因素不孕行IVF-ET助孕治療的患者(123例)及凍融胚胎移植患者(108例),測定血清及卵泡液中25(OH)D水平,根據(jù)血清及卵泡液25(OH)D水平分為25nmol/L組、,25~50 nmol/L組和50 nmol/L組,分別比較各組間的胚胎種植率、臨床妊娠率和早期流產(chǎn)率有無差異。又分別按照妊娠結(jié)局分為妊娠組和未妊娠組,比較兩組間血清及卵泡液25(OH)D水平有無差異。結(jié)果:1.在體外受精-胚胎移植患者中,血清25(OH)D水平與卵泡液中25(OH)D水平呈顯著正相關(guān)(r=0.811,P0.001);2.血清不同25(OH)D水平各組中,50 nmol/L組的胚胎種植率(53.3%)及臨床妊娠率(73.3%)均顯著高于25 nmol/L組(27.5%和28.0%)(P0.05);3.卵泡液不同25(OH)D水平各組中,25~50 nmol/L組及50 nmol/L組胚胎種植率(分別為42.3%、70.0%)及臨床妊娠率(分別為66.7%、80.0%)均顯著高于25 nmol/L組(21.4%和28.6%)(P均0.05)。各組間早期流產(chǎn)率比較無顯著性差異(P0.05);4.妊娠組血清及卵泡液25(OH)D水平[分別為(38.41±13.58)nmol/L、(32.03±13.35)nmol/L]均顯著高于未妊娠組[分別為(29.68±12.23)nmol/L、(23.41±11.54)nmol/L](P0.05);5.在凍融胚胎移植患者中,血清中50 nmol/L組的胚胎種植率顯著高于25~50nmol/L組、25 nmol/L組(47.4%vs 14.5%,47.4%vs24.7%)。血清中50 nmol/L組的臨床妊娠率顯著高于25 nmol/L組及25~50 nmol/L組(85.7%vs32.3%,85.7%vs47.4%)。3組間的早期流產(chǎn)率比較差異無統(tǒng)計學(xué)意義(P0.05);6.妊娠組血清25(OH)D水平[(38.39±13.66)nmol/L]顯著高于未妊娠組[(27.73±11.99)nmol/L](P0.05)。結(jié)論:不孕癥患者普遍存在維生素D缺乏,ART患者的妊娠率下降可能與維生素D缺乏有關(guān)。
[Abstract]:Aim: to investigate the relationship between serum and follicular fluid 25 hydroxyvitamin D [25(OH)D] levels and early pregnancy outcomes in IVF-ETs and frozen-thawed embryo transfer (IVF-ETs) patients. Methods: from September 2014 to May 2015, 123 patients with infertility treated with IVF-ET for tubal infertility and 108 patients with frozen-thawed embryo transfer were selected from the Department of Reproduction, first Hospital of Shanxi Medical University. The levels of 25(OH)D in serum and follicular fluid were measured. The serum and follicular fluid 25(OH)D levels were compared between the two groups according to the outcome of pregnancy. The result is 1: 1. There was a significant positive correlation between serum 25(OH)D level and 25(OH)D level in follicular fluid in patients with in vitro fertilization and embryo transfer. The embryo implantation rate (53.3%) and clinical pregnancy rate (73.3%) of 50 nmol/L group were significantly higher than that of 25 nmol/L group (27.5%) and 28.0% (P 0.05%). The embryo implantation rate and clinical pregnancy rate of 2550 nmol/L group and 50 nmol/L group were significantly higher than that of 25 nmol/L group (21.4%) and 28.6% nmol/L group (80.0%). There was no significant difference in early abortion rate among groups. The levels of 25(OH)D in serum and follicular fluid in pregnancy group [38.41 鹵13.58 nmol / L] were significantly higher than those in non-pregnant group [29.68 鹵12.23 nmol / L, 23.41 鹵11.54)nmol/L] (P 0.05). The clinical pregnancy rate of 50 nmol/L group was significantly higher than that of 25 nmol/L group and 2550 nmol/L group. There was no significant difference in the early abortion rate between the two groups. The serum 25(OH)D level in pregnancy group [38.39 鹵13.66)nmol/L] was significantly higher than that in non-pregnant group [27.73 鹵11.99)nmol/L] P 0.05. Conclusion: the decrease of pregnancy rate in infertility patients with vitamin D deficiency and art may be related to vitamin D deficiency.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R714.8

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