扳机后人绒毛膜促性腺激素水平对体外受精-胚胎移植助孕结局的影响  

Effect of trigger offspring chorionic gonadotropin levels on pregnancy outcomes assisted by in vitro fertilization and embryo transfer

作　　者：苏丽霄[1] 刘敏[1] 张静[1] 张富青[1] SU Li-xiao;LIU Min;ZHANG Jing;ZHANG Fu-qing(Department of Reproductive Genetics,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市妇幼保健院生殖遗传科,郑州450000

出　　处：《医药论坛杂志》2024年第19期2022-2026,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210780)。

摘　　要：目的研究体外受精-胚胎移植术治疗患者扳机后人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)水平对助孕结局的影响。方法将2021年12月—2022年12月在郑州市妇幼保健院进行体外受精-胚胎移植术的494例患者纳入研究,按照扳机后12 h血清HCG水平分为A组与B组,A组HCG≤90 IU/L(n=127),B组HCG>90 IU/L(n=367),对比两组的基线资料,观察扳机后两组的促排卵治疗周期、实验室结局及临床结局,用Spearman法分析HCG水平与卵母细胞质量之间的关系。结果A组BMI均高于B组,差异有统计学意义(P<0.05),年龄、不孕年限、不孕类型、基础雌二醇(E_(2))水平、基础促卵泡生成素(FSH)水平、抗苗勒管激素水平(AMH)对比,差异无统计学意义(P>0.05);两组间促性腺激素(Gn)启动量、Gn使用天数、Gn使用总量、HCG日E_(2)水平及HCG日子宫内膜厚度,差异无统计学意义(P>0.05);A组获卵数低于B组,成熟卵子数高于B组,差异有统计学意义(P<0.05);调整女方年龄、女方BMI、HCG日卵泡均径等因素,扳机后血HCG水平对获卵数、成熟卵子数无影响(P>0.05);两组间2PN数、2PN卵裂数、优质胚胎数差异无统计学意义(P>0.05)。两组间卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)发生率、HCG阳性率、临床妊娠率差异无统计学意义(P>0.05)。结论HCG扳机后血清HCG水平与患者BMI呈负相关。扳机后HCG水平对获卵数、成熟卵子数无影响。Objective To investigate the effects of trigger progenitor human chorionic gonadotropin(HCG)levels on assisted pregnancy outcomes in patients treated with embryo transfer.Methods A total of 494 patients who underwent in vitro fertilization and embryo transfer in Zhengzhou Maternal and Child Health Hospital from December 2021 to December 2022 were included in the study and divided into group A and group B according to serum HCG level 12 hours after trigger,with HCG≤90 IU/L(n=127)in group A and HCG>90 IU/L in group B(n=367).The baseline data of the two groups were compared to observe the cycle of ovulation induction therapy,laboratory outcome and clinical outcome of the two groups after trigger,and the relationship between HCG level and oocyte quality was analyzed by Spearman method.Results BMI of group A was higher than that of group B(P<0.05),but there were no significant differences in age,infertility years and infertility types,base E_(2)level,base FSH level,AMH between group A and group B(P>0.05).There were no significant differences in the amount of Gn initiation,the days of Gn use,the total amount of Gn use,the E_(2)level of HCG days and the endometrial thickness of HCG days between the two groups(P>0.05).The number of eggs obtained in group A were lower than those in group B,and the number of mature eggs were higher than those in group B,with statistical significance(P<0.05).After adjusting for age,BMI and average follicle diameter of HCG day,blood HCG level had no effect on the number of eggs obtained and the number of mature eggs(P>0.05).There was no significant difference in 2PN number,2PN cleavage number and quality embryo number between the two groups(P>0.05).There were no significant differences in the incidence of OHSS,positive rate of HCG and clinical pregnancy between the two groups(P>0.05).Conclusion Serum HCG level after HCG trigger is negatively correlated with BMI of patients.The level of HCG after trigger have no effect on the number of eggs harvested and the number of mature eggs.

关 键 词：体外受精-胚胎移植术 扳机 人绒毛膜促性腺激素水平 临床结局 

分 类 号：R321[医药卫生—人体解剖和组织胚胎学]