在长方案IVF-ET患者中波塞冬1组发生的相关因素分析  

Analysis of related factors of Poseidon group 1 in patients with long protocol of IVF-ET

作　　者：刘尧芳 范凌晔 LIU Yao-fang;FAN Ling-ye(Department of Reproductive Technology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000;Department of Gynecology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000)

机构地区：[1]西南医科大学附属医院生殖医学科,泸州646000 [2]西南医科大学附属医院妇科,泸州646000

出　　处：《生殖医学杂志》2022年第9期1182-1187,共6页Journal of Reproductive Medicine

基　　金：四川省科学技术厅项目(2022YFS0082);西南医科大学附属医院博士启动基金(19084)。

摘　　要：目的探索在促性腺激素释放素激动剂(GnRH-a)长方案IVF-ET患者中波塞冬1组发生的相关因素。方法回顾性分析2018年10月至2021年5月在我院行IVF-ET助孕共393例患者的临床资料,根据获卵数不同分为两组:获卵数≤9枚的为波塞冬1组(125例),获卵数>9枚的为正常反应组(268例)。比较两组患者的基础资料、促排卵情况以及新鲜胚胎移植的妊娠结局,采用Logistic回归分析波塞冬1组的相关影响因素,采用受试者工作特征曲线(ROC)分析各影响因素对波塞冬1组的预测价值。结果本研究中波塞冬1组的发生率为31.81%(125/393)。波塞冬1组的窦卵泡计数(AFC)和抗苗勒管激素(AMH)显著低于正常反应组(P<0.05),而年龄、bFSH、FSH/LH显著高于正常反应组(P<0.05);两组间的体质量指数(BMI)、不孕年限、不孕类型、bE_(2)、孕酮(P)、bLH、T和PRL水平比较均无显著差异(P>0.05)。波塞冬1组促排卵后血清E_(2)水平(Gn 4 d、Gn 7 d和HCG日)、P水平(Gn 7 d和HCG日)、获卵数、MⅡ卵数、2PN数均显著低于正常反应组(P<0.05),Gn启动剂量和Gn总量均显著高于正常反应组(P<0.05);两组间LH水平(Gn 4 d、Gn 7 d和HCG日)、Gn天数、MⅡ卵率、2PN率、优质胚胎率比较均无显著差异(P>0.05)。波塞冬1组和正常反应组的新鲜胚胎移植分别为90例和94例,两组间移植胚胎数、胚胎种植率、临床妊娠率、流产率和活产率比较均无显著差异(P>0.05)。Logistic回归分析显示,促排卵前患者的AFC[OR=0.697,95%CI(0.625,0.777)]、AMH水平[OR=0.860,95%CI(0.766,0.965)]及HCG日E_(2)水平[OR=0.999,95%CI(0.999,1.000)]是波塞冬1组的显著相关因素(P<0.05)。ROC结果显示,AFC、AMH和HCG日E_(2)的曲线下面积(AUC)分别为0.835、0.671和0.767,截断值分别为13.50枚、2.77 ng/ml和9540.33 pmol/L。结论GnRH-a长方案IVF-ET患者波塞冬1组的发生与促排卵前患者AFC、AMH和HCG日E_(2)水平有关。Objective:To explore the related factors of Poseidon group 1 in IVF-ET patients with the GnRH agonist long protocol.Methods:The clinical data of 393 patients who underwent IVF-ET in the Affiliated Hospital of Southwest Medical University from October 2018 to May 2021 were analyzed retrospectively.The patents were divided into two groups according to the number of oocytes retrieved:Poseidon group 1 with≤9 oocytes retrieved(n=125)and normal response group with>9 oocytes retrieved(n=268).The general conditions and the status of ovulation induction and the pregnancy outcome of fresh embryo transfer were compared between the two groups.The related factors of Poseidon group 1 were analyzed by logistic regression analysis.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of each influencing factor on Poseidon group 1.Results:The incidence of Poseidon group 1 was 31.81%(125/393).The antral follicles count(AFC)and anti-Mullerian hormone(AMH)level were significantly lower in Poseidon group 1 than those in the normal response group(P<0.05),while the age,basal FSH and ratio of FSH/LH were significantly higher(P<0.05).There were no significant differences in basal levels of E_(2),testosterone,progesterone and PRL,and duration of infertility between the two groups(P>0.05).The E_(2) levels on Gn 4 day,Gn 7 day&HCG day,progesterone levels on Gn 7 day&HCG day,the number of oocytes retrieved,number of MⅡoocytes,and number of 2PN in Poseidon group 1 were significantly lower than those in the normal response group(P<0.05),while the initial dose of Gn and the total dose of Gn were significantly higher than those in the normal response group(P<0.05).There were no differences in LH levels on Gn 4 day,Gn 7 day&HCG day,the Gn days,and good-quality embryos rate between the two groups(P>0.05).There were 90 fresh embryo transfers in Poseidon 1 group and 94 in normal response group.There were no significant differences in transferred embryos number,embryo implantation rate,clinical pregnancy rate,sp

关 键 词：波塞冬1组 体外受精-胚胎移植 长方案 相关因素 

分 类 号：R711.6[医药卫生—妇产科学]