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目的探讨胚胎植入前遗传学检测-非整倍筛查(PGT-A)周期中发生早期妊娠丢失的相关影响因素。方法回顾性分析2017年1月至2020年6月于河南省人民医院生殖中心行PGT-A治疗且获得妊娠患者的214个周期资料,根据是否能够持续妊娠分为持续妊娠组(n=187)和早期妊娠丢失组(n=27),比较两组患者的基本临床资料、促排卵情况,Logistic回归分析发生早期妊娠丢失的影响因素。结果单因素分析显示除持续妊娠组的移植日子宫内膜厚度显著高于早期妊娠丢失组[(9.73±1.63)mm vs.(9.59±1.71)mm,P<0.05]外,两组患者间的女方年龄、男方年龄、体质量指数(BMI)、不孕类型、不孕年限、孕次、复发性流产病史、多囊卵巢综合征疾病因素、AMH、基础FSH、基础LH、窦卵泡计数(AFC)、抗β2糖蛋白抗体、抗心磷脂抗体IgM等基本资料比较均无显著性差异(P>0.05)。促排卵情况中两组间获卵总数、成熟卵子数、囊胚形成数、囊胚发育天数及质量等比较均无显著性差异(P>0.05)。Logistic多因素回归分析显示,移植日子宫内膜厚度对妊娠结局的影响有统计学意义[OR=0.713,95%CI(0.528,0.964),P=0.028]。结论在PGT-A周期中,移植日子宫内膜厚度是早期妊娠丢失的影响因素。
Abstract：Objective:To explore the related influencing factors of early pregnancy loss in preimplantation genetic testing-aneuploidy(PGT-A)cycle.Methods:The data of 214 PGT-A cycles in the Reproductive Center of Henan Provincial People's Hospital from January 2017 to June 2020 were retrospectively analyzed. The cycles were divided to continuous pregnancy group(n=187)and early pregnancy loss group(n=27)according to whether the pregnancy was continuous. The basic clinical data and ovulation induction were compared between the two groups, and the influencing factors of early pregnancy loss were analyzed by logistic regression.Results:Univariate analysis showed that the endometrial thickness of the continuous pregnancy group was significantly higher than that of the early pregnancy loss group[(9.73±1.63)mm vs.(9.59±1.71)mm, P<0.05]. There were no significant differences in the female age, the male age, body mass index(BMI),type of infertility, years of infertility, gravidity, history of recurrent miscarriage, polycystic ovary syndrome disease factors, AMH levels, basic FSH levels, basic LH levels, antral follicle counting(AFC),anti-β2 glycoprotein antibody and anticardiolipin antibody IgM between the two groups(P>0.05). There were no significant differences in the total number of oocytes retrieved, the number of mature oocytes, the number of blastocysts, the development days and quality of blastocysts between the two groups(P>0.05). Logistic multivariate regression analysis showed that the influence of endometrial thickness on pregnancy outcome was significant[OR=0.713,95%CI(0.528,0.964),P=0.028].Conclusions:In the PGT-A cycle, the endometrial thickness on transplantation day is an influencing factor for early pregnancy loss.
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基本信息:
中图分类号:R714.8
引用信息:
[1]范英英,李蕾,李净羽,等.非整倍体筛查周期中发生早期妊娠丢失的影响因素分析[J].生殖医学杂志,2021,30(07):913-917.
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