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2019, 03, v.28 249-257
HCG日血清雌激素水平对不同年龄段女性活产率的预测价值
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邮箱(Email): tjczjh@163.com;
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发布时间: 2019-03-15
出版时间: 2019-03-15
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摘要:

目的探讨新鲜周期人绒毛膜促性腺激素(HCG)日血清雌二醇(E2)水平是否可作为预测活产的指标。方法回顾性分析2013年1月至2016年12月在中国医科大学附属盛京医院生殖中心首次行新鲜周期移植患者的4 200个周期,根据HCG日血清E2水平将患者分为3组,A组:E2≤9 175pmol/L;B组:9 175pmol/L 16 515pmol/L。再将每组按照患者不同年龄分为3个亚组:A1、B1、C1组:年龄<30岁;A2、B2、C2组:30~<35岁;A3、B3、C3组:35~<40岁。分别比较不同年龄段女性E2水平对活产率及妊娠结局的影响差异。通过计算受试者工作特征(ROC)曲线下面积与建立逻辑回归分析模型评估E2水平与活产率的关系。结果年龄<30岁患者中B1组的活产率(43.05%)显著高于A1组和C1组(分别为34.44%、34.73%,P<0.05);30~<35岁患者中B2组的活产率显著高于C2组(38.58%vs.32.84%,P<0.05);30~<35岁患者中A3、B3、C3三组活产率分别为23.85%、24.00%及27.94%,组间比较差异无统计学意义(P>0.05)。ROC曲线下面积计算结果显示HCG日血清E2水平对于活产率无显著影响;Logistic回归分析模型显示HCG日血清E2水平与活产率之间亦无显著相关性。当年龄小于35岁时,促排卵方案和优质胚胎率与活产率显著性相关;当年龄35~<40时,获卵数、移植胚胎数及优质胚胎率与活产率显著性相关。结论不同年龄段女性HCG日血清E2水平与活产率无显著相关性,血清E2水平并不能预测活产。

Abstract:

Objective:To determine if the serum E2 concentration on HCG day can be used as a predictor of live birth rate.Methods:A retrospective investigation was made based on 4 200 cycles with the first fresh embryo transfer conducted in our center from January 2013 to December 2016.The patients were divided into three groups according to the E2 level on HCG day:group A with E2≤9 175 pmol/L,group B with 9 175 pmol/L16 515 pmol/L.The patients were further divided into three subgroup respectively according to patients' ages:group A1,B1,C1 with age<30,group A2,B2,C2 with age 30~<35,group A3,B3,C3 with age 35~<40.The pregnant outcomes were compared among the groups.The area under the ROC was calculated and the logistic regression analysis was made to assess the association between E2 level and live birth rate.Results:The live birth rate in group B1(43.05%)was significantly higher than group A1(34.44%)and group C1(34.73%)(P<0.05).In the patients with age 30~<35,the live birth rate in group B2(38.58%)was significantly higher than group C2(32.84%)(P<0.05).In the patients with age 35~<40,the live birth rate was not significantly different among group A3,B3,C3(23.85% vs.24.00% vs.27.94%)(P>0.05).The results of ROC showed that the serum E2 level on the HCG day had no effect on the live birth rate.Logistic regression analysis showed that the serum E2 level on the HCG day had no correlation with live birth rate.When the age was below 35 years,stimulation protocols and high quality embryos rate were significantly correlated with live birth rate.When the age was 35~<40,the number of retrieved oocytes and embryos transferred and the high quality embryos rate were significantly correlated with live birth rate.Conclusions:E2 concentration on the HCG day is not associated with live birth rate,which cannot be a predictor of live birth rate of the female of different ages.

参考文献

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基本信息:

中图分类号:R714.8

引用信息:

[1]董萌,邱佳慧,谭季春.HCG日血清雌激素水平对不同年龄段女性活产率的预测价值[J].生殖医学杂志,2019,28(03):249-257.

发布时间:

2019-03-15

出版时间:

2019-03-15

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