人工周期冻融胚胎移植患者移植前后雌激素浓度变化及与治疗结局的关系  

Changes of estrogens before and after artificial cycle frozen embryo transfer and their relationship with treatment outcomes

作　　者：樊艳玲 樊月 丰程文 刘宝莲[1] 韩宝生[1] FAN Yanling;FAN Yue;FENG Chengwen;LIU Baolian;HAN Baosheng(Reproductive Medicine Center,Tangshan Maternal and Child Health Hospital,Tangshan 063003,Hebei,China;North China University of Technology,Tangshan 063210,Hebei,China)

机构地区：[1]唐山市妇幼保健院生殖医学中心,河北唐山063003 [2]华北理工大学,河北唐山063210

出　　处：《西部医学》2023年第12期1803-1807,共5页Medical Journal of West China

基　　金：河北省医学科学研究课题(20221767)。

摘　　要：目的分析人工周期冻融胚胎移植(FET)患者移植前后雌激素浓度变化及与治疗结局的关系。方法选取2021年1月—2022年1月唐山市妇幼保健院接受人工周期FET的患者105例,根据治疗后的妊娠结局分为妊娠组(47例)和未妊娠组(58例)。于FET前、治疗后第7天、14天检测患者雌激素[雌二醇(E 2)、孕酮(P)]浓度和子宫内膜血流参数[子宫内膜血管指数(VI)、血流指数(FI)及血管血流指数(VFI)]。采用ROC曲线评估雌激素浓度对妊娠结局的预测效能。采用Pearson相关性分析雌激素与子宫内膜血流参数的关系。结果各时间点妊娠组血清E2、P浓度显著高于未妊娠组(P<0.05)。妊娠组与未妊娠组患者FET后VI比较差异无统计学意义(P>0.05),妊娠组FI和VFI显著高于未妊娠组(P<0.05)。FET后第7天的E2浓度预测妊娠结局的AUC为0.929,明显优于FET前(0.860)和FET后第14天(0.839)(P<0.05);FET后第7天的P水平预测妊娠结局的AUC为0.793,与FET前(0.823)和FET后第14天(0.746)相比无明显差异(P>0.05)。FET后第7天血清E 2、P浓度与FET后子宫VI水平呈负相关,与FI、VFI水平呈正相关(均P<0.05)。结论人工周期FET患者FET后雌激素水平明显增加,血清E2、P浓度均对妊娠结局有较好的预测价值。Objective To analyze the changes of estrogens before and after artificial cycle frozen embryo transfer(FET)and their relationship with treatment outcomes.Methods A total of 105 patients undergoing artificial cycle FET were enrolled from January 2021 to January 2022.According to pregnancy outcomes after treatment,they were divided into pregnancy group(47 cases)and non-pregnancy group(58 cases).Before and after FET,levels of estrogen[estradiol(E 2),progesterone(P)]and endometrial blood flow parameters were detected.The predictive efficiency of estrogens for pregnancy outcomes was evaluated by ROC curves.The relationship between estrogens and endometrial blood flow parameters was analyzed by Pearson correlation analysis.Results The levels of serum E 2 and P in pregnancy group were significantly higher than those in non-pregnancy group(P<0.05).After FET,there was no significant difference in VI between the two groups(P>0.05),but FI and VFI in pregnancy group were significantly higher than those in non-pregnancy group(P<0.05).AUC of E 2 at 7d after FET for predicting pregnancy outcomes was 0.929,significantly better than that before FET(0.860)and at 14d after FET(0.839)(P<0.05).AUC of P at 7d after FET for predicting pregnancy outcomes was 0.793,without significant difference compared with that before FET(0.823)and at 14d after FET(0.746)(P>0.05).The levels of serum E 2 and P at 7d after FET were negatively correlated with uterine VI level at 1d after FET,while positively correlated with FI and VFI levels(P<0.05).Conclusion The levels of estrogens significantly increase after artificial cycle FET.Serum E 2 and P have good predictive value for pregnancy outcomes.

关 键 词：人工周期 冻融胚胎移植 雌激素 妊娠结局 

分 类 号：R321[医药卫生—人体解剖和组织胚胎学] R711.6[医药卫生—基础医学]