PCOS冻胚移植后血hCG水平与妊娠结局的分析  

Analysis of hCG level and pregnancy outcomes after frozen embryo transfer in PCOS

作　　者：姜小花 郭培培[1,2,3] 李彩华 张洲 曹云霞[1,2,3] 魏兆莲 Jiang Xiaohua;Guo Peipei;Li Caihua(Dept of Obstetrics and Gynecology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract(Anhui Medical University),Hefei 230022;Anhui Province Key Laboratory of Reproductive Health and Genetics,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院妇产科,合肥230032 [2]国家卫生健康委配子及生殖道异常研究重点实验室,合肥230022 [3]生殖健康与遗传安徽省重点实验室,合肥230022

出　　处：《安徽医科大学学报》2021年第2期322-325,332,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省重点研究和开发计划(编号:1804h08020265)。

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者冻胚移植后14 d人绒毛膜促性腺激素(hCG)水平与妊娠结局的关系及其相关影响因素。方法对安徽医科大学第一附属医院607例PCOS患者和1 636例输卵管因素和(或)男方因素的非PCOS患者(对照组)进行回顾性分析,比较两组患者间基线资料、冻胚移植后14 d血hCG水平及妊娠结局。分析hCG水平对PCOS患者冻胚移植活产的预测价值及其相关影响因素。结果 PCOS组与对照组比较,冻胚移植后14 d hCG水平降低,活产率降低(P<0.05)。移植后14 d hCG是PCOS冻胚移植活产的独立预测因素,其ROC曲线下面积(AUC)为0.903,95%CI=0.878~0.928(P<0.001),最佳临界值为1 634.25 IU/L,灵敏度为74.6%,特异度为88.5%。体质量指数(BMI)与hCG水平呈负相关(P<0.001)。结论 PCOS患者冻胚移植后14 d血hCG水平较输卵管因素和(或)男方因素非PCOS患者更低,移植后14 d血hCG水平是PCOS患者活产的独立预测因子,与BMI呈负相关。Objective To investigate the relationship between the level of the human chorionic gonadotropin(hCG) 14 days after frozen embryo transfer and pregnancy outcomes in polycystic ovary syndrome(PCOS) and its related factors.Methods 607 PCOS patients and 1636 controls were analyzed retrospectively in our hospital.The baseline data,hCG level 14 days after frozen embryo transfer and pregnancy outcomes were compared between the two groups.The predictive value of hCG level 14 days after embryo transfer on the live birth of PCOS patients and its related factors were analyzed.Results Compared with the control group,the level of hCG 14 days after frozen embryo transfer in PCOS group decreased,and the live birth rate decreased(P<0.05).The level of hCG 14 days after frozen embryo transfer was an independent predictor of live birth in PCOS patients.The area under the ROC curve(AUC) was 0.903,95% CI=0.878-0.928(P<0.001),the cut-off value was 1 634.25 IU/L with a 74.6% sensitivity and a 88.5% specificity.BMI was negatively correlated with hCG level(P<0.001).Conclusion The level of hCG 14 days after frozen embryo transfer in PCOS patients is low,which is an independent predictor of live birth in PCOS patients and has a high predictive value.hCG level is negatively correlated with BMI.

关 键 词：多囊卵巢综合征 人绒毛膜促性腺激素 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]