摘要
目的探讨辅助生殖技术中Gn的使用时间和剂量对后续冻融胚胎移植周期妊娠结局的影响。方法回顾性分析2018年10月至2019年10月在山西医科大学第一医院生殖医学中心行体外受精-胚胎移植患者的临床资料,选出符合条件的周期共1046个,根据促排过程中Gn使用时间不同分为3个组(Gn使用时间<10 d,107个;10 d≤Gn使用时间<15 d,777个;Gn使用时间≥15 d,162个),对不同组的妊娠结局(胚胎种植率、临床妊娠率、早期流产率、异位妊娠率,持续妊娠率)采用单因素及多因素Logistic回归分析。结果通过对不同Gn使用时间及使用剂量组妊娠结局指标的交互作用分析,发现当Gn使用时间≥15 d且总剂量≥40支时,后续胚胎的种植率[β=-0.12,95%CI(-0.24,0.01),P=0.03]以及临床妊娠率[OR=0.51,95%CI(0.34,0.89),P=0.04]显著下降。结论在控制性超促排卵过程中,Gn的使用时间≥15 d且总剂量≥40支时可能会降低后续冻融胚胎移植的妊娠率及胚胎种植率。
Objective To explore the effect of the usage time and the dose of Gn in assisted reproductive technology on the pregnancy outcome of the subsequent freeze-thaw embryo transfer cycles.Methods The data were retrospectively collected from the Reproductive Medicine Center of the First Hospital of Shanxi Medical University from October 2018 to October 2019.A total of 1046 eligible cycles were analyzed for the inclusion.According to the usage time of Gn in the period of controlled ovarian hyperstimulation,the cohort was divided into three groups(<10 d group,n=107;10 d≤Gn usage time<15 d group,n=777;≥15 d,n=162).The pregnancy outcomes(embryo implantation rate,clinical pregnancy rate,early miscarriage rate,ectopic pregnancy rate,sustained pregnancy rate)in different groups were analyzed by single-factor and multi-factor logistic regression analysis.Results The analysis of interact effect of the pregnancy outcome indicators in different usage time and dosage of Gn showed that embryo implantation rate[β=-0.12,95%CI(-0.24,0.01),P=0.03]and clinical pregnancy rate[OR=0.51,95%CI(0.34,0.89),P=0.04]were decreased significantly when the Gn usage time more than 15 d and the total dosage more than 40.Conclusion During the cycle of controlled ovarian hyperstimulation,the pregnancy rate and the embryo implantation rate in subsequent freeze-thaw embryo transfer may reduce when the accumulation time more than 15 d and the accumulated dosage of Gn more than 40.
作者
仉一
王丽媛
土增荣
田秀珠
ZHANG Yi;WANG Liyuan;TU Zengrong;TIAN Xiuzhu(Reproductive Center,First Clinical Medical College of Shanxi Medical University,Taiyuan 030001,China)
出处
《山西医科大学学报》
CAS
2020年第10期1128-1132,共5页
Journal of Shanxi Medical University
关键词
促性腺激素
冻融胚胎
移植周期
妊娠结局
gonadotropin
freeze-thaw embryo
transfer cycles
pregnancy outcome
