自然周期冻融胚胎移植日血清雌二醇、孕酮水平对妊娠结局的影响

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摘要目的探讨自然周期冻融胚胎移植(NT-FET)中胚胎移植日血清雌二醇(E2)、孕酮(P)水平对妊娠结局的影响。方法回顾性分析2019年5月至2021年5月于山东中医药大学附属医院生殖中心行NT-FET的不孕症患者共503个周期的临床资料,根据有无活产结局分为活产组140个周期和无活产组363个周期,比较两组移植日血清激素水平及其他相关资料。另根据503个周期移植日血清孕酮水平四分位数、移植日血清雌二醇水平四分位数再各分四个亚组,比较四组的活产率及临床妊娠率,并分析移植日血清雌二醇、孕酮水平及其他相关资料对活产结局的影响。结果活产组和无活产组的移植日血清雌二醇水平、移植日血清孕酮水平、移植胚胎数、移植优质胚胎数、年龄、移植日内膜厚度差异有统计学意义(P＜0.05),体重、体质指数差异无统计学意义(P＞0.05)。移植日血清孕酮水平四组间、移植日血清雌二醇水平四组间活产率及临床妊娠率差异均无统计学意义(P＞0.05),通过组间两两比较,16.4 ng/mL＜P≤21.6 ng/mL组的活产率显著高于P≤12.7 ng/mL组(P=0.008)。移植日血清孕酮水平升高(P=0.021,OR=0.84,95%CI=0.73~0.97)、移植优质胚胎数增加(P=0.048,OR=0.71,95%CI=0.51~1.00)是活产结局的保护因素;年龄增长(P=0.020,OR=1.35,95%CI=1.05~1.75)、移植日血清雌二醇水平升高(P=0.017,OR=1.21,95%CI=1.04~1.42)是活产结局的危险影响因素。结论 NT-FET移植日血清雌二醇、孕酮水平是妊娠结局的影响因素。

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关键词 ：冻融胚胎移植, 移植日, 孕酮, 雌二醇, 妊娠结局

Abstract：Objective To discuss the effect of serum estradiol(E2) and progesterone(P) levels on transplantation day that are in natural cycle frozen embryo transfer(NT-FET) on pregnancy outcomes.Methods A total of 503 NT-FET cycles from May 2019 to May 2021 in the reproductive center of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were analyzed retrospectively. Based on the pregnancy outcomes, these cycles were divided into the live birth group(140 cycles)and no live birth group(363 cycles).The serum hormone levels on transplantation day and other relevant information were compared between the two groups. In addition, 503 cycles were divided into four subgroups according to the quartile of serum progesterone levels on transplantation day and the quartile of serum estradiol levels on transplantation day, respectively. The live birth rate and clinical pregnancy rate between the four groups and between the two groups were compared. The effects of serum estradiol and progesterone levels on transplantation day, and other related variables on the outcome of live birth were analyzed.Results There was significant difference in serum estradiol levels, serum progesterone levels, number of transferred embryos, number of high-quality transferred embryos, female age, and intimal thickness between the live birth group and no live birth group(P<0.05). There was no significant difference in body weight and body mass index(P>0.05).There was no significant difference in live birth rate and clinical pregnancy rate across the four subgroups of serum progesterone levels on transplantation day or the four subgroups of serum estradiol levels on transplantation day. Through the comparison between the two groups, the live birth rate of the 16.4 ng/mL<P≤21.6 ng/mL group was significantly higher than that of the P≤12.7 ng/mL group(P=0.008). The levels of serum progesterone on transplantation day(OR=0.84, 95%CI=0.73-0.97; P=0.021) and the number of high-quality embryos transferred(OR=0.71, 95%CI=0.51-1.00; P=0.048) were positive factors affecting the outcome of live birth; female age(OR=1.35, 95%CI=1.05-1.75; P=0.020) and serum estradiol levels on transplantation day(OR=1.21, 95%CI=1.04-1.42; P=0.017) were negative factors affecting the outcome of live birth.Conclusion The levels of serum estradiol and progesterone on NT-FET transplantation day are the influencing factors of pregnancy outcome.

Key words： frozen embryo transfer transplantation day progesterone estradiol pregnancy outcome

收稿日期: 2022-09-02

ZTFLH:	R71
	R17

通讯作者: 张宁(ning_zhang1975@163.com)

引用本文:

徐书凝, 贾珠, 张宁. 自然周期冻融胚胎移植日血清雌二醇、孕酮水平对妊娠结局的影响[J]. 中国生育健康杂志, 2024, 35(1): 34-39. XU Shuning, ZHANG Ning, Jia Zhu. Effect of serum estradiol and progesterone levels on transplantation day that are in natural cycle frozen embryo transfer on pregnancy outcomes. Chinese Journal of Reproductive Health, 2024, 35(1): 34-39.

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http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2024/V35/I1/34

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