摘要
目的:探讨拮抗剂方案取卵后48 h雌二醇(estradiol,E_(2))水平较取卵前24 h下降幅度对新鲜胚胎移植妊娠结局的影响。方法:回顾性分析2017年1月—2021年3月在南京医科大学附属妇产医院生殖医学中心采用拮抗剂方案超促排卵并行新鲜胚胎移植413个周期的临床资料,根据取卵后48 h较取卵前24 h E_(2)下降幅度按四分位数分为4组。A组:降低幅度范围在总体降低范围的0~25.0%;B组:25.1%~50.0%;C组:50.1%~75.0%;D组:75.1%~100.0%。比较各组促排卵情况、胚胎参数及妊娠结局,并通过Logistic回归分析E_(2)降低幅度与活产率的关系。结果:4组的促性腺激素(gonadotropins,Gn)总量、拮抗剂使用时间、活产率、种植率和临床妊娠率比较,差异均有统计学意义(均P<0.05)。A组活产率大于D组,B组活产率大于C组及D组,A组、B组种植率大于D组,差异均有统计学意义(均P<0.008 3)。校正组间差异因素后,A、B组的活产率均高于于D组(OR=2.079,95%CI:1.138~3.799,P=0.017;OR=2.187,95%CI:1.213~3.944,P=0.009)。结论:在拮抗剂方案中,取卵后48 h较取卵前24 h E_(2)降低幅度较大的患者新鲜胚胎移植的活产率低于变化较小的患者。
Objective:To study the effect of the descend range of estradiol(E_(2))at 48 h after oocyte retrieval compared with 24 h before oocyte retrieval on the pregnancy outcomes of fresh embryo transfer in the antagonist regimen.Methods:A retrospective study was done on the clinical data from 413 cycles of fresh embryo transfer,from January 2017 to March 2021.According to the descend range of E_(2) 48 h after oocyte retrieval compared with 24 h before oocyte retrieval,they were divided into four groups according to the quartile method.Group A:The descend range is 0-25.0%of the overall descend range;Group B:25.1%-50.0%;Group C:50.1%-75.0%;Group D:75.1%-100.0%.The ovulation induction,embryological outcome and pregnancy outcomes were compared,and the relationship between E_(2) reduction and live birth rates was analyzed by logistic regression.Results:There were significant differences in the total amount of Gn,days of antagonist use,live birth rates,implantation rates and clinical pregnancy rates among the four groups(all P<0.05).The live birth rate of group A was higher than group D,group B was higher than those of group C and group D,and the implantation rates of group A and group B were higher than group D(all P<0.0083).After adjusting for the factors of differences among groups,the live birth rates of groups A and B were significantly higher than those of group D(OR=2.079,95%CI:1.138-3.799,P=0.017;OR=2.187,95%CI:1.213-3.944,P=0.009).Conclusions:In the antagonist regimen,the live birth rate of fresh embryo transfer in patients with a greater descend range of E_(2) at 48 h after oocyte retrieval is lower than that in patients with less descend range of E_(2).
作者
周羽西
张娟
张娟娟
凌秀凤
赵纯
ZHOU Yu-xi;ZHANG Juan;ZHANG Juan-juan;LING Xiu-feng;ZHAO Chun(Center of Reproductive Medicine,Women′s Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing 210004,China)
出处
《国际生殖健康／计划生育杂志》
CAS
2022年第4期265-269,共5页
Journal of International Reproductive Health/Family Planning
基金
国家自然科学基金面上项目(81971386)。
关键词
促性腺素释放激素
雌二醇
排卵诱导
体外受精
精子注射
细胞质内
胚胎移植
活产
妊娠结局
Gonadotropin-releasing hormone
Estradiol
Ovulation induction
Fertilization in vitro
Sperm injections,intracytoplasmic
Embryo transfer
Live birth
Pregnancy outcome
