GnRH-a预处理对正常血清CA125子宫内膜异位症患者冻融胚胎移植结局的影响  

Influence of gonadotropin releasing hormone agonist on pregnancy outcome in frozen-thawed embryo transfer cycles for patients with EMs in normal serum CA125

作　　者：张雅梦 李彩华 于震 周平[1,2,3] 曹云霞 Zhang Yameng;Li Caihua;Yu Zhen(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, Hefei 230032;Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei 230032)

机构地区：[1]安徽医科大学第一附属医院妇产科,合肥230022 [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230032 [3]生殖健康与遗传安徽省重点实验室,合肥230032

出　　处：《安徽医科大学学报》2021年第7期1123-1127,共5页Acta Universitatis Medicinalis Anhui

基　　金：中国医学科学院中央级公益性科研院所基本科研业务费专项资金(编号:2019PT310002);国家重点研发计划生殖健康及重大出生缺陷防控研究重点专项项目(编号:2017YFC1002004);安徽高校协同创新项目(编号:GXXT-2019-044)。

摘　　要：目的探讨促性腺激素释放激素激动剂(GnRH-a)预处理对正常血清CA125的子宫内膜异位症(EMs)合并不孕症患者的冻融胚胎移植(FET)结局的影响。方法回顾性分析146例FET前血清CA125处于正常值内(0~35 U/ml)未接受GnRH-a预处理的EMs患者的妊娠结局,获得ROC曲线并取得最佳截断点,根据最佳截断点及FET前是否应用GnRH-a将228例EMs患者分为A组(CA125为0~16.79 U/ml,未使用GnRH-a)、B组(CA125为16.79~35 U/ml,未使用GnRH-a)与C组(CA125为16.79~35 U/ml,使用GnRH-a),比较3组患者的一般情况及FET妊娠结局。结果3组患者的年龄、不孕年限、体质指数、移植胚胎数、优质胚胎率等一般资料和胚胎情况差异均无统计学意义。B、C组与A组的胚胎种植率、临床妊娠率差异有统计学意义,且B组与C组间胚胎种植率、临床妊娠率差异有统计学意义(P<0.05);3组间内膜厚度、异位妊娠率与活产率差异无统计学意义。结论EMs患者FET前血清CA125≥16.79 U/ml可能预示不良结局,在FET前应用GnRH-a可能改善此类患者的不良结局。Objective To investigate the influence of gonadotropin releasing hormone agonist(GnRH-a)on pregnancy outcomes in frozen-thawed embryo transfer cycles for patients with endometriosis and infertility in normal serum CA125.Methods A retrospective analysis was performed on 146 FET cycles in patients who didn′t accept GnRH-a with EMs in normal serum CA125 before FET(0-35 U/ml),the ROC curve and the best statistical cutoff values were obtained.According to the best statistical cutoff values and whether GnRH-a was applied before FET,228 patients were divided into Group A(CA125 was 0-16.79 U/ml without GnRH-a),group B(CA125 was 16.79-35 U/ml without GnRH-a)and Group C(CA125 was 16.79-35 U/ml with GnRH-a),and the general condition and pregnancy outcome were compared among the three groups.Results There were no statistically significant differences between the three groups in age,years of infertility,body mass index,number of transplanted embryos and high quality embryo rate.There were statistically significant differences in embryo implantation rate and clinical pregnancy rate between Group B,C and Group A,and there were statistically significant differences in embryo implantation rate and clinical pregnancy rate between group B and Group C(P<0.05).There were no statistically significant differences in endometrial thickness,ectopic pregnancy rate and live birth rate among the three groups.Conclusion Serum CA125≥16.79 U/ml before FET in EMs patients can predict the adverse pregnancy outcome,and applying GnRH-a before FET can improve the adverse pregnancy outcome in EMs patients.

关 键 词：子宫内膜异位症 CA125 体外受精-胚胎移植 促性腺激素释放激素激动剂 

分 类 号：R711.71[医药卫生—妇产科学]