HCG日孕酮水平对多囊卵巢综合征患者IVF/ICSI助孕妊娠结局的影响  

Effect of progesterone levels on HCG day on the outcome of IVF/ICSI assisted pregnancy in patients with polycystic ovary syndrome

作　　者：王琳[1] 苏迎春[1] Wang Lin;Su Yingchun(Reproductive Medicine Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院生殖医学中心,郑州450000

出　　处：《中国实用医刊》2024年第8期29-33,共5页Chinese Journal of Practical Medicine

摘　　要：目的探讨接受体外受精/卵胞质内单精子注射(IVF/ICSI)助孕治疗的多囊卵巢综合征(PCOS)患者在控制性超促排卵过程中人绒毛膜促性腺激素(HCG)日孕酮水平对临床妊娠结局的影响,为临床移植策略的制定提供思路。方法回顾性分析2020年1月至2021年12月于郑州大学第一附属医院接受IVF/ICSI助孕治疗的270例PCOS患者的临床资料,每例患者均采用早卵泡期长效长方案促排卵,最终获卵数≥5枚且获得至少1枚可移植胚胎。根据HCG日孕酮水平将入选患者分为四组,比较各组间临床资料和妊娠结局的差异,探究HCG日孕酮水平对PCOS患者妊娠结局的影响并绘制受试者工作特征曲线评价其预测价值。结果单因素Logistic回归结果显示HCG日孕酮水平与PCOS患者临床妊娠率不具有相关性(OR=1.080;95%CI:0.749~1.557),与活产率显著相关(OR=0.593;95%CI:0.415~0.848)。多因素回归模型显示HCG日孕酮水平与临床妊娠率不具有相关性(OR=1.176;95%CI:0.783~1.766),与活产显著相关(OR=0.649;95%CI:0.436~0.964)。针对HCG日孕酮水平的受试者工作特征曲线分析,结果显示其曲线下面积为0.590,95%CI为0.522~0.658(P=0.009),cut-off值为2.02。结论多囊卵巢综合征患者IVF/ICSI助孕周期中,HCG日孕酮水平升高不影响患者的临床妊娠率,但当HCG日孕酮水平>2.02 ng/mL时,活产率明显降低。Objective To investigate the impact of progesterone levels on human chorionic gonadotrophin(HCG)day on clinical pregnancy outcomes in polycystic ovary syndrome patients undergoing in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)assisted pregnancy therapy during controlled ovarian hyperstimulation,providing insights for the development of clinical transplantation strategies.Methods The data of 270 patients with polycystic ovary syndrome who received IVF/ICSI assisted pregnancy treatment from January 2020 to December 2021 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Each patient was treated with an early follicular phase long-acting rectangular protocol to induce ovulation,resulting in the acquisition of at least 5 eggs and the acquisition of at least 1 transferable embryo.According to the progesterone level on HCG day,the selected patients were divided into four groups,and the differences in clinical data and pregnancy outcomes between each group were compared.The impact of HCG day on pregnancy outcomes of PCOS patients was explored,and draw receiver operating characteristic curve to evaluate its predictive value.Results The results of univariate logistic regression showed that there was no correlation between progesterone levels and clinical pregnancy rate on HCG day in PCOS patients(OR=1.080,95%CI:0.749-1.557),but there was a significant correlation with live birth rate(OR=0.593,95%CI:0.415-0.848).The multiple regression model showed that there was no correlation between progesterone levels and clinical pregnancy rate on HCG day(OR=1.176,95%CI:0.783-1.766),but there was a significant correlation with live birth(OR=0.649,95%CI:0.436-0.964).The analysis of the receiver operating characteristic curve of subjects with progesterone levels on HCG day showed that their area under the curve was 0.590,95%CI was 0.522-0.658(P=0.009),and the cut-off value was 2.02.Conclusions During the IVF/ICSI assisted pregnancy cycle in patients with polycystic ovary syndrome,an

关 键 词：多囊卵巢综合征 人绒毛膜促性腺激素日 孕酮 临床妊娠 

分 类 号：R711.75[医药卫生—妇产科学]