薄型子宫内膜患者冻融胚胎移植周期妊娠结局的预测模型构建  

Construction of Prediction Model for Pregnancy Outcome of Frozen-thawed Embryo Transfer Cycle in Patients with Thin Endometrium

作　　者：田静[1,2] 凌秀凤[1] TIAN Jing;LING Xiufeng(Reproductive Medicine Center,Women′s Hospital of Nanjing Medical University,Nanjing 210000,China;Department of Obstetrics and Gynecology,People′s Hospital of Yangzhong City,Yangzhong 212200,China)

机构地区：[1]南京医科大学附属妇产医院生殖医学中心,南京210000 [2]扬中市人民医院妇产科,江苏扬中212200

出　　处：《医学综述》2023年第18期3715-3719,3724,共6页Medical Recapitulate

基　　金：国家自然科学基金(81871210)。

摘　　要：目的探讨薄型子宫内膜患者冻融胚胎移植(FET)周期妊娠结局的影响因素并构建列线图预测模型。方法选择2019年1月至2021年12月南京医科大学附属妇产医院生殖医学中心收治的152例FET周期获得临床妊娠的薄型子宫内膜患者作为妊娠组,选题同期收治的152例FET周期未获得临床妊娠的薄型子宫内膜患者作为未妊娠组。由研究者查阅并统计两组患者的基线资料,采用Logistic回归分析薄型子宫内膜患者FET周期妊娠结局的影响因素,并构建列线图模型。结果未妊娠组患者年龄大于妊娠组[(33±5)岁比(31±4)岁](P<0.01),子宫内膜厚度小于妊娠组[(6.6±0.7)mm比(7.0±0.6)mm](P<0.01),基础抗米勒管激素(AMH)水平低于妊娠组[(4.4±1.6)μg/L比(5.3±1.9)μg/L](P<0.01)。多因素Logistic回归分析结果显示,高龄是患者未获得临床妊娠的危险因素(OR=1.081,95%CI 1.023~1.144,P=0.006),基础AMH、子宫内膜厚度高是其保护因素(OR=0.820,95%CI 0.712~0.946,P=0.006;OR=0.489,95%CI 0.336~0.711,P<0.001)。根据Logistic回归分析结果构建预测薄型子宫内膜患者FET周期妊娠结局的列线图模型,结果显示,一致性指数为0.705,列线图模型的校正曲线与理想曲线趋于一致,受试者工作特征曲线下面积为0.705。结论年龄、子宫内膜厚度、基础AMH是薄型子宫内膜患者FET周期妊娠结局的影响因素,本研究构建的列线图模型可较为准确地预测患者未获得临床妊娠的风险。Objective To explore the influencing factors of pregnancy outcome in the frozen-thawed embryo transfer(FET)cycle of patients with thin endometrium and build a nomogram prediction model.Methods A total of 152 patients with thin endometrium who received clinical pregnancy during the FET cycle from the Reproductive Medicine Center of Women′s Hospital of Nanjing Medical University between Jan.2019 and Dec.2021 were included as a pregnancy group,and 152 patients with thin endometrium who did not get clinical pregnancy during the FET cycle were included as a non-pregnancy group.The baseline data of both groups were reviewed and counted by the researchers.The influencing factors of FET cycle pregnancy outcomes in patients with thin endometrium were analyzed by Logistic regression analysis,and a nomogram model was constructed.Results The age of the non-pregnancy group was higher than that of the pregnancy group[(33±5)years vs(31±4)years](P<0.01);the endometrial thickness was smaller than that of the pregnancy group[(6.6±0.7)mm vs(7.0±0.6)mm](P<0.01);basal anti-Müllerian hormone(AMH)levels was lower than that of the pregnancy group[(4.4±1.6)μg/L vs(5.3±1.9)μg/L](P<0.01).Multivariate Logistic regression analysis showed that older age was the risk factor for not obtaining clinical pregnancy(OR=1.081,95%CI 1.023-1.144,P=0.006),while higher basal AMH and endometrial thickness were the protective factors(OR=0.820,95%CI 0.712-0.946,P=0.006;OR=0.489,95%CI 0.336-0.711,P<0.001).According to the results of Logistic regression analysis,a nomogram model was constructed to predict the risk of not obtaining clinical pregnancy in FET cycles in patients with thin endometrium.The results showed that the consistency index was 0.705.The calibration curve of the nomogram model was consistent with the ideal curve,and the area under the receiver operating characteristic curve was 0.705.Conclusion Age,endometrial thickness and basal AMH are the influencing factors of pregnancy outcome in FET cycle of patients with thin endometrium,an

关 键 词：薄型子宫内膜 冻融胚胎移植 妊娠结局 抗米勒管激素 

分 类 号：R711.6[医药卫生—妇产科学]