常规IVF受精失败相关危险因素的Logistic回归分析  

Logistic regression analysis of risk factors associated with fertilization failure in routine IVF

作　　者：方群英 吴丽敏[1] 童先宏 栾红兵 金仁桃 周桂香 刘雨生 Fang Qunying;Wu Limin;Tong Xianhong(The First Affiliated Hospital of USTC,Anhui Provincial Hospital,Hefei 230001;Graduate School of Anhui University of traditional Chinese Medicine,Hefei 230001)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)生殖中心,合肥230001 [2]安徽中医药大学研究生院,合肥230001

出　　处：《现代妇产科进展》2020年第3期199-202,207,共5页Progress in Obstetrics and Gynecology

基　　金：国家自然科学基金面上项目(No:81373671);国家自然科学基金青年基金项目(No:81000237)

摘　　要：目的:探讨常规体外受精(IVF)失败的危险因素,为防止常规IVF受精失败和授精方式的选择提供临床依据。方法回顾分析2014年1月至2018年1月于安徽省立医院生殖中心行常规IVF助孕受精失败的260个周期(受精失败组)和受精正常的1233个周期(受精正常组),比较两组周期患者的一般资料、实验室相关指标及临床诊断等因素,并进行相关危险因素的Logistic回归分析。结果两组患者的年龄、不孕年限、获卵数、成熟卵母细胞数、HCG日E2水平、促排方案、体重指数(BMI)、免疫相关指标(包括ANA、ACA、A-β2-GP1、ATA、ATG)、甲状腺功能、D-二聚体、PCOS、DOR、男方轻度弱精子症比较,差异均无统计学意义(P>0.05)。两组的HCG日P水平、CA125水平、原发性不孕症、子宫内膜异位症、男方中度弱精子症比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,两组患者的HCG日P水平(OR=2.534,95%CI为2.135~3.213)、CA125水平(OR=1.236,95%CI为3.281~5.864)、原发性不孕症(OR=2.675,95%CI为1.423~2.547)、子宫内膜异位症(OR=3.585,95%CI为2.557~3.986)、男方中度弱精子症(OR=2.341,95%CI为1.213~2.327)存在显著差异(P<0.05)。结论HCG日P水平、CA125水平、原发性不孕症、子宫内膜异位症、男方中度弱精子症是受精失败发生的危险因素,临床上可综合考虑以上危险因素选择合理的受精方式,以降低受精失败率。Objective:To explore the risk factors of conventional IVF in vitro fertilization failure,to provide a clinical basis for preventing the failure of conventional IVF fertilization and the choice of insemination methods.Methods:From Jan.2014 to Jan.2018,260 cycles(failure group)of conventional IVF assisted fertilization and 1233 cycles(normal group)of normal fertilization were analyzed retrospectively.To compare the general data,laboratory related indexes and clinical diagnosis of the two groups of patients.The significant differences(P<0.05)were included in the logistic regression,and perform logistic regression analysis of relevant risk factors.Results:The patients'age,number of infertility,number of oocytes,number of mature oocytes,the E2 lever of HCG day,BMI,immune related indexes(including ANA,ACA,A-beta 2-GP1),thyroid function,D-two polymer,PCOS,DOR,male mild asthenospermia were not statistically significant(P>0.05).The P lever of HCG day,CA125,primary infertility,endometriosis,and moderate tonic sperm in menwere were statistically significant(P<0.05).After multivariate logistic regression analysis,the results showed that there were significant differences between the P lever of HCG day(OR=2.534,95%CI:2.135,3.213),CA125(OR=1.236,95%CI:3.281,5.864),primary infertility(OR=2.675,95%CI:1.423,2.547),endometriosis(OR=3.585,95%CI:2.557~3.986),and moderate to weak sperm disease(OR=2.341,95%CI:1.213,2.327)in the two groups(P<0.05).Conclusion:CA125,primary infertility,endometriosis and mild tonic sperm in males are the risk factors for failure of fertilization.Clinically,the above risk factors can be considered to select a reasonable fertilization method to reduce the failure rate of fertilization.

关 键 词：体外受精 受精失败 LOGISTIC回归 危险因素 

分 类 号：R711.6[医药卫生—妇产科学]