IVF-ET过程中流产因素分析  

Analysis of Abortion during IVF-ET Treatment

作　　者：王俊超[1] 徐凤琴[1] 罗海宁[1] 马俊芳[1] 张云山[1] 

机构地区：[1]天津市中心妇产科医院生殖助孕中心,300100

出　　处：《天津医药》2012年第7期663-665,共3页Tianjin Medical Journal

摘　　要：目的:探讨在体外受精-胚胎移植(IVF-ET)过程中引起患者流产的因素。方法:选择2005年1月—2009年12月行IVF-ET且成功临床妊娠的患者1195例,其中流产患者203例,包括早期流产患者150例,为A组;晚期流产患者53例,为B组;持续妊娠及分娩患者992例,为C组。分别对3组患者年龄、体质量指数(BMI)、超排卵(COH)情况、临床妊娠情况及是否行减胎等治疗进行比较和分析。结果:A组患者年龄、促性腺激素(Gn)总量明显高于C组;B组BMI明显高于A组、C组。A组ET后第14天β-hCG水平明显低于B组、C组而单胎妊娠率明显高于B、C两组,B组胎儿畸形率、减胎率明显高于A组、C组。3组患者注射hCG日发育卵泡数、获卵数、雌二醇水平及受精方式差异无统计学意义。结论:高BMI、大剂量Gn超排卵以及多胎妊娠和减胎术是IVF-ET时造成流产的重要因素,ET后14d血β-hCG水平偏低提示胚胎发育不良、早期流产的风险大。Objective： to investigate the causes of abortion during in vitro fertilization and embryo transfer （IVF/ET）. Methods： Two hundred and three patients including 150 patients with early abortion （group A） and 53 patients with late abortion （group B） were enrolled, while 992 patients with continuing pregnancy and full-term pregnancy were as control （group C）. The age, body mass index （BMI）, hyperstimulation （COH） and clinical pregnancy results were compared between three groups. Results： The age, total dosage of gonadotropin （Gn） and the single pregnancy rate were significantly higher in group A than those in group B and group C. The value of BMI was higher in group B than that of group A and group C. The level of β-hCG was lower in group A 14 days after ET treatment than that of group B and group C, but the pregnancy rate was significantly higher in group A than that of group B and group C. Rates of fetal malformation and fetal reduction were significantly higher in group B than those in group A and group C. There were no significant differences in numbers of follicle development and egg retrieval, type of insemination and the estradiol level on the day of hCG injection between three groups. Conclusion： Increasing BMI and large dose of Gn during COH can influence the receptivity of the endometrium and the embryo implantation. Multiple pregnancy and fetal reduction method are one of reasons causing late stage abortion. Low β-hCG level after 14 days of ET suggests the high risk of early abortion.

关 键 词：受精 体外 胚胎移植 流产 促性腺素类 雌二醇 排卵 

分 类 号：R714.21[医药卫生—妇产科学]