摘要
目的探讨基础促甲状腺激素(TSH)水平对IVF-ET患者胚胎发育及临床结局的影响。方法回顾性分析2016年1月至2018年12月于河北省计划生育科学技术研究院/河北省生殖医学中心首次接受IVF-ET治疗的1449例患者的临床资料,根据患者基础TSH水平分为3组:TSH<2.5 mU/L组(A组,1021例);2.5 mU/L≤TSH<4.0 mU/L(B组,358例);4.0 mU/L≤TSH<5.91 mU/L(C组,70例)。比较各组患者的一般资料、实验室指标及移植后妊娠结局的差异。结果三组间女方平均年龄及BMI、男方平均年龄、不孕年限、IVF和ICSI占比、促排方案、精液来源均无统计学差异(P>0.05);三组间MⅡ卵率、受精率、2PN率、2PN卵裂率、种植率均无统计学差异(P>0.05),但C组种植率趋低;B组的平均获卵数显著高于A组和C组,而可利用胚胎率显著低于A组和C组(P<0.05);三组间HCG阳性率、临床妊娠率、异位妊娠率、早期流产率、活产率、新生儿出生体重及身长均无统计学差异(P>0.05),但C组的临床妊娠率和活产率趋低而早期流产率趋高。结论2.5 mU/L≤TSH<5.91 mU/L对IVF-ET助孕结局影响不明显,TSH≥4.0 mU/L时是否需要行IVF-ET助孕前的干预性治疗仍需进一步探讨。
Objective:To study the effects of basic thyroid stimulating hormone(TSH)on embryonic development and clinical outcomes in the patient with IVF-ET.Methods:The clinical data of 1449 women who firstly received IVF-ET treatment in the Research Institute of Family Planning/Reproductive Medicine Center in Hebei Province from January 2016 to December 2018 were retrospectively analyzed.The patients were divided into three groups according to the basic TSH levels:TSH<2.5 mIU/L(group A,n=1021),2.5 mIU/L≤TSH<4.0 mIU/L(group B,n=358),4.0 mIU/L≤TSH<5.91 mIU/L(group C,n=70).The general information,laboratory indicators and pregnancy outcomes after transplantation were compared among the groups.Results:There were no significant differences in female and male mean age,infertility years,proportion of IVF/ICSI,ovulation induced method and sperm source among the three groups(P>0.05).The MⅡrate,fertilization rate,2PN rate,2PN cleavage rate and implantation rate were also not significantly different among the three groups(P>0.05),but the implantation rate of group C was lower than group A and group B.The average number of oocytes retrieved was significantly higher,but the available embryo rate was significantly lower in group B compared with group A and group C(P<0.05).There were no significant differences in HCG positive rate,clinical pregnancy rate,ectopic pregnancy rate,early abortion rate,live birth rate,birth weight and body length among the three groups(P>0.05),but the clinical pregnancy rate and live birth rate of group C was lower than group A and group B,the early abortion rate of group C was higher than group A and group B.Conclusions:There was no significant effect on the ART outcomes when 2.5 mIU/L≤TSH<5.91 mIU/L.Whether the intervention treatment before IVF-ET is needed or not is still to be further investigation when TSH≥4.0 mIU/L.
作者
王雪莹
郭薇
谢聪聪
郭晓丽
姚冠峰
和伟
刘效群
WANG Xue-ying;GUO Wei;XIE Cong-cong;GUO Xiao-li;YAO Guan-feng;HE Wei;LIU Xiao-qun(Reproductive Medicine Center,Research Institute of Family Planning of Hebei Province,Key Laboratory for Family Planning&Birth Health of the National Health&Family Planning Committee,Key Medical Laboratory of Hebei Province,Shijiazhuang 050071)
出处
《生殖医学杂志》
CAS
2020年第8期1008-1012,共5页
Journal of Reproductive Medicine
基金
河北省科技计划项目(17277798D)。
