摘要
目的分析体外受精-胚胎移植(IVF-ET)术后7天血浆D-二聚体水平与临床结局的相关性。方法选择2014年2至4月在兰州大学第一医院生殖医学专科医院行ⅣF-ET的患者新鲜胚胎移植102个周期,解冻胚胎移植51个周期,均于ⅣF.ET术后7天采血,检测血浆D-二聚体水平,并分析D-二聚体与临床结局的相关性。结果鲜胚移植周期D-二聚体水平较冻胚移植周期明显升高(t=-8.031,P<0.01),临床妊娠率、种植率、早期流产率比较均无显著性差异(均P>0.05)。鲜胚移植周期妊娠组与未妊娠组相比,D-二聚体水平无显著性差异(P>0.05),冻胚移植周期妊娠组与未妊娠组相比,D-二聚体水平无显著性差异(P>0.05)。鲜胚移植周期D-二聚体水平以中位数0.678分组,小于0.678μg/mL组与大于0.678μg/mL组相比,临床妊娠率无显著性差异(56.86%vs 50.98%,P>0.05),种植率无显著性差异(42.31%vs 33.96%,P>0.05),早期流产率有显著性差异(3.45%vs 23.08%,x^2=4.755,P<0.05)。鲜胚移植周期D-二聚体水平与人绒毛膜促性腺激素日雌二醇水平(r=0.513,P<0.01)及获卵数(r=0.395,P<0.01)显著相关。结论鲜胚移植周期由于超促排卵导致血清雌激素升高,血液高凝状态,纤溶亢进,血浆D-二聚体升高,胚胎发育可能受负面影响导致流产率升高。
Objective To analyze the correlation between plasma D-dimer level at 7 days after in vitro fertilization-embryo transfer （ IVF-ET） and clinical outcomes.Methods From February to April in 2014 totally 102 cycles of fresh embryo transfer and 51 cycles of frozen thawed embryo transfer were selected from patients undergoing IVF-ET in Reproductive Medicine Hospital of First Hospital of Lanzhou University.Seven days after IVF-ET, blood was collected to test plasma D-dimer level to conduct statistical analysis on the correlation between D-dimer level and clinical outcomes.Results The D-dimer level in the cycles of fresh embryo transfer was significantly higher than that in those of frozen thawed embryo transfer （t=-8.031,P〈0.01）, but there was no significant difference in clinical pregnancy rate, implantation rate and early abortion rate （ all P〉0.05 ） .There was no significant difference between pregnant group and non-pregnant group in fresh embryo transfer cycle in D-dimer level （P〉0.05）, so was between pregnant group and non-pregnant group in frozen thawed embryo transfer cycle in D-dimer level （P〉0.05）.D-dimer level of the cycle of fresh embryo transfer was divided by the median of 0.678μg/mL.The groups with lower and higher value were not significantly different in clinical pregnancy rate （56.86%vs 50.98%,P〉0.05） and implantation rate （42.31%vs 33.96%, P〉0.05）, but they were obviously different in early abortion rate （3.45% vs 23.08%,χ^2 =4.755,P〈0.05）.In the cycle of fresh embryo transfer, D-dimer level was significantly correlated with E2 level （r=0.513,P〈0.01） and number of retrieved oocytes （ r =0.395, P 〈0.01 ） on HCG day.Conclusion In the cycle of fresh embryo transfer, the superovulation leads to the rise of serum estrogen and plasma D-dimer, hypercoagulable state, hyperfibrinolysis and the increase of abortion rate resulting from the negative influence on embryonic development.
出处
《中国妇幼健康研究》
2015年第4期760-762,765,共4页
Chinese Journal of Woman and Child Health Research
关键词
体外受精-胚胎移植
D-二聚体
凝血
流产
in vitro fertilization-embryo transfer（IVF-ET）
D-dimer
coagulation
abortion
