冻融囊胚移植周期临床妊娠影响因素分析及预测模型建立  

Influencing factors of clinical pregnancy in frozen-thawed blastocyst transplantation cycle and establishment of prediction model

作　　者：段如冰 梁晓东[1] 李云 饶东平 郭江华[1] Duan Rubing;Liang Xiaodong;Li Yun;Rao Dongping;Guo Jianghua(Reproductive Medical Center,Jiangmen Central Hospital,Jiangmen 529001,Guangdong,China;Department of Record Room,Jiangmen Central Hospital,Jiangmen 529001,Guangdong,China)

机构地区：[1]江门市中心医院,生殖医学诊疗中心,广东江门529001 [2]江门市中心医院,病案室,广东江门529001

出　　处：《贵州医药》2020年第10期1521-1524,共4页Guizhou Medical Journal

摘　　要：目的研究冻融囊胚移植周期临床妊娠的影响要素,建立囊胚解冻移植(BM-FET)的妊娠率预测模型。方法选择2011年12月至2018年12月江门市中心医院生殖医学中心行BM-FET患者645例,进行回顾研究。跟据移植术后35 d超声检查结果,分为临床妊娠组(A组,n=355)和未妊娠组(B组,n=290)。比较两组患者的一般情况、基础内分泌、内膜情况和胚胎情况,行单因素及多因素分析,建立临床妊娠成功率预测模型。结果临床妊娠成功组移植优胚数大于临床妊娠失败组(P<0.05)。多因素Logistic回归结果显示,BM-FET临床妊娠的独立影响因素包括:LH、FSH、FSH/LH、女方年龄、不孕年限、BMI及移植优胚数。通过建模,得到BM-FET临床妊娠率预测方程(P)为:P=1/(1+y);y=exp[-(-0.619-0.049×年龄+0.069×体重指数-0.173×不孕年限+0.428×基础FSH-0.073×LH-0.307×FSH/LH+0.459×移植优胚数)]。根据预测概率与实际妊娠数据制作ROC曲线,求得曲线下面积为0.751,差异有统计学意义(P=0.000)。提示该方程在预测BM-FET临床妊娠的概率方面有较大的应用价值。结论影响BM-FET临床妊娠的独立风险因素包括患者LH、FSH、FSH/LH、女方年龄、不孕年限、BMI及移植优胚数。ROC曲线检验显示,根据上述风险因素建立的临床妊娠率预测模型具有一定的诊断价值。Objective To explore the influencing factors of clinical pregnancy in frozen-thawed blastocyst transplantation cycle(BM-FET),and to establish a prediction model of clinical pregnancy in BM-FET cycle.Methods A retrospective cohort study was conducted among 645 frozen-thawed blastocyst transplantation patients in the Reproductive Medicine Center of Jiangmen Central Hospital from December 2011 to December 2018.The patients,according to the color Doppler ultrasonographic information(D35 days),were divided into two groups which were clinical pregnant group(n=355)and failure group(n=290).The general conditions,basic endocrine,embryonic status,endometrial status were compared between the two groups.The influence factor of clinical pregnancy in BM-FET cycle was found by logistic regression analysis.Finally,a full variable risk prediction model of clinical pregnancy in BM-FET cycle was established and tested.Results The number of good embryos transplanted in the successful group was higher than that in the failed group(P<0.05).Logistic regression analysis showed that age,body mass index,infertility years,basic FSH,LH,FSH/LH and number of good embryos were independent influencing factors of clinical pregnancy in BM-FET cycle.Through the establishment of full variable regression model,the pregnancy rate prediction model(P)was established as follows that P=1/(1+y),y=exp[-(-0.619-0.049×age+0.069×body mass index-0.173×infertility years+0.428×basic FSH-0.073×LH-0.307×FSH/LH+0.459×number of eugenic embryos)].The ROC curve was made between the predictive probability and clinical pregnancy data.The area under the curve was 0.751(P=0.000).It was suggested that the multivariate logistic regression prediction model of clinical pregnancy related to BM-FET cycle has certain diagnostic value.Conclusions It is concluded that the factors affecting BM-FET clinical pregnancy include age,body mass index,infertility years,basic FSH,LH,FSH/LH and the number of transplanted good embryos.The clinical pregnancy prediction model based on th

关 键 词：冻融囊胚移植周期 影响因素 预测模型 LOGISTIC回归分析 

分 类 号：R714[医药卫生—妇产科学]