摘要
目的探讨新鲜周期hCG日孕酮(P4)水平对全胚冷冻周期累积活产率的影响。方法回顾性分析2016年1月至2018年12月本中心行IVF第1周期治疗的≤35岁使用拮抗剂或者激动剂方案的全胚冷冻患者资料,按hCG日孕酮水平分为四组:组1(<0.50 ng/mL,n=801),组2(0.50~1.14 ng/mL,n=1626),组3(1.15~1.49 ng/mL,n=499)和组4(≥1.50 ng/mL,n=997),其中以组2为对照组。结果与对照组相比,组1优质胚胎率和冷冻胚胎率显著增加(P <0.01),组4优质胚胎率、冷冻胚胎率显著下降(P <0.01)。累积活产率组4显著低于对照组(69.71%vs. 75.83%,P <0.001),其他各组差异无统计学意义。经多因素回归分析显示,与对照组相比,组4累积活产率显著降低(AOR=0.759,95%CI:0.63~0.91,P <0.01);组1不会影响全冻周期累积活产率(AOR=0.901,95%CI:0.74~1.10,P> 0.05)。结论 hCG日P4≥1.5 ng/mL显著降低累积活产率,可能与优质胚胎率,冷冻胚胎率下降有关;P4 <0.5 ng/mL不会影响胚胎质量,也不会影响全胚冷冻周期的累积活产率。
Objective To explore the effect of progesterone(P4)level on hCG day on embryo quality,and cumulative live birth rate in freeze-all strategy patients.Methods From January 2016 to December 2018,patients under 36 years old with first IVF cycle,antagonist or agonist protocol in freeze-all strategy were retrospectively analyzed and divided into four groups according to their hCG-day P4 levels:group 1(<0.50 ng/mL,n=801),group 2(0.50~1.14 ng/mL,n=1626),group 3(1.15~1.49 ng/mL,n=499)and group 4(≥1.50 ng/mL,n=997).The control group was group 2.Results Compared with the control group,the rate of high-quality embryos and frozen embryos in group 1 increased significantly(P<0.01),while that in group 4 decreased significantly(P<0.01).The cumulative live rate in group 4 were significantly lower than those in the control group(69.71%vs.75.83%,P<0.001).Multivariate regression analysis showed that group 4 significantly reduced the cumulative live birth rate(AOR=0.759,95%CI:0.63~0.91,P<0.01);group 1 did not affect the cumulative live birth rate(AOR=0.901,95%CI:0.74~1.10,P>0.05).Conclusion P4 level≥1.5 ng/mL on hCG day significantly reduced the cumulative live rate,which may relate to the decrease of the high-quality embryo rate and frozen embryo rate;P4 level<0.5 ng/mL did not affect embryo quality and cumulative live birth rate in freeze-all strategy cycles.
作者
詹少泉
郑海燕
曹明珠
刘见桥
毛玉玲
龙晓林
刘寒艳
ZHAN Shaoquan;ZHENG Haiyan;CAO Mingzhu;LIU Jianqiao;MAO Yuling;LONG Xiaolin;LIU Hanyan(Department of Obstetrics and Gynecology,Center for Reproductive Medicine,Key Lab-oratory for Major Obstetric Diseases of Guangdong Province,Key Laboratory for Reproductive Medicine of Guangdong Province,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China)
出处
《实用医学杂志》
CAS
北大核心
2021年第13期1690-1694,共5页
The Journal of Practical Medicine
基金
国家自然科学基金(编号:81701400)。
关键词
孕酮
胚胎质量
全胚冷冻
活产
累积活产
progesterone
embryo quality
freeze-all strategy
live birth
cumulative live birth
