维生素D联合抗苗勒管激素预测不孕症患者IVF-ET妊娠结局的临床价值  

Clinical value of the vitamin D level combined with the anti-Müllerian hormone level for predicting the pregnancy outcomes of infertile patients after in vitro fertilization-embryo transfer

作　　者：戚静宜 牛吉峰 张婵 柳胜贤 邢冠琳 王芳 QI Jingyi;NIU Jifeng;ZHANG Chan;LIU Shengxian;XING Guanlin;WANG Fang(Luoyang Central Hospital Affiliated to Zhengzhou University,Henan Province,471300)

机构地区：[1]郑州大学附属洛阳中心医院,471300

出　　处：《中国计划生育学杂志》2023年第2期380-384,共5页Chinese Journal of Family Planning

基　　金：河南省医学科技攻关计划联合共建项目(HGJ20191216);洛阳市科技发展计划项目(2001026A)。

摘　　要：目的:探讨维生素D联合抗苗勒管激素(AMH)预测不孕症患者体外受精-胚胎移植(IVF-ET)妊娠结局的临床价值。方法:回顾性分析2019年5月-2021月12月在本院进行IVF-ET的402例不孕症患者临床资料,根据IVF-ET术后妊娠结局分为临床妊娠组220例和未妊娠组182例。入院后检测血清维生素D、AMH水平,绘制受试者工作特征曲线(ROC)分析维生素D、AMH对不孕症患者IVF-ET妊娠结局的预测价值,多因素logistic回归分析妊娠结局影响因素。结果:未妊娠组血清维生素D、AMH均低于临床妊娠组(均P<0.05)。ROC曲线显示,血清维生素D、AMH预测患者IVF-ET妊娠结局的曲线下面积分别为0.768、0.816,截断值分别为5.86ng/ml、15.10ng/ml,敏感度分别为93.2%、93.2%,特异度分别为54.2%、67.6%;血清维生素D联合AMH预测曲线下面积为0.892,敏感度、特异度分别为86.3%、85.3%。多因素logistic回归析显示,血清维生素D低、AMH低、受精率低、年龄大均为影响不孕症患者IVF-ET妊娠的因素(P<0.05)。结论:不孕症IVF-ET术后未妊娠患者血清维生素D、AMH均较低,两项指标联合应用可作为评估IVF-ET术后妊娠的有效指标。Objective: To explore the clinical value of the vitamin D level combined with the anti-Müllerian hormone(AMH) level for predicting the pregnancy outcomes of infertile patients after in vitro fertilization-embryo transfer(IVF-ET). Methods: The clinical data of 402 infertile patients who had undergone IVF-ET from May 2019 to December 2021 were analyzed retrospectively. According to the pregnancy outcomes after IVF-ET, these patients were divided into group A(220 patients with clinical pregnancy) and group B(182 patients without clinical pregnancy). The levels of serum vitamin D and AMH of the patients in the two groups were detected after admission. Receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of the serum vitamin D and AMH levels of the patients for their pregnancy outcomes after IVF-ET. The influencing factors of the pregnancy outcomes of the infertile patients after IVF-ET were analyzed by multivariate logistic regression analysis. Results: The serum vitamin D and AMH levels of the patients in group B were significantly lower than those of the patients in group A(all P<0.05). ROC curve showed that the areas under curve of the serum vitamin D level and the AMH level of the patients for predicting their pregnancy outcomes after IVF-ET were 0.768 and 0.816, the cut-off values of which were 5.86ng/ml and 15.10ng/ml, the sensitivity of which were 93.2% and 93.2%, and the specificity of which were 54.2% and 67.6%. The area under curve, the sensitivity, and the specificity of the combined levels of serum vitamin D and AMH of the patients for predicting their pregnancy outcomes after IVF-ET were 0.892, 86.3%, and 85.3%, respectively. Multivariate logistic regression analysis showed that the low serum vitamin D level, the low AMH level, the low fertilization rate,and the advanced age of the infertility patients were all the factors affecting their pregnancy after IVF-ET(P<0.05).Conclusion:Both the serum vitamin D level and the AMH level of infertile patients without pregnancy af

关 键 词：不孕症 体外受精-胚胎移植 维生素D 抗苗勒管激素 妊娠 影响因素 预测 

分 类 号：R714.8[医药卫生—妇产科学]