子宫内膜厚度对辅助生殖周期妊娠结局的影响及预测价值  

The Impact and Predictive Value of Endometrial Thickness on Pregnancy Outcomes in Fresh Cycle Embryo Transfer

作　　者：程冠 丁锦丽[1] 张艳[1] CHENG Guan;DING Jinli;ZHANG Yan(Department of Clinical Laboratory,Institute of Translational Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院检验医学中心,武汉430060

出　　处：《微循环学杂志》2025年第1期67-75,82,共10页Chinese Journal of Microcirculation

基　　金：国家重点研发计划项目(2023YFC2705700)。

摘　　要：目的:探究胚胎移植日子宫内膜厚度(EMT)对新鲜周期胚胎移植临床妊娠、活产及流产的影响,并评估其预测价值。方法:选取2019-2022年于武汉大学人民医院生殖医学中心接受体外受精/卵胞浆内单精子显微注射(IVF/ICSI)的2119例新鲜周期胚胎移植受试者。运用Logistic回归分析EMT与妊娠结局的相关性。依据胚胎移植日EMT将受试者分为<9mm、9-11mm、11-13mm、13-15mm和≥15mm组,对比5组对象的基线特征以及妊娠结局。通过亚组分析,探究不同胚胎移植阶段EMT对妊娠结局的影响。采用受试者工作特征(ROC)曲线分析EMT对新鲜周期胚胎移植妊娠结局的预测能力。结果:多因素Logistic回归模型分析表明,EMT与临床妊娠(OR=1.06,95%CI:1.03-1.10,P<0.01)和活产(OR=1.07,95%CI:1.03-1.11,P<0.01)呈显著正相关,与流产率无显著相关性(P>0.05)。新鲜周期胚胎移植不同EMT组对比显示,随着EMT增加,临床妊娠率和活产率显著升高(P<0.05),但不同组间流产率无显著差异(P>0.05)。亚组分析中,卵裂期移植时,多元Logistic回归显示EMT与临床妊娠(OR=1.09,95%CI:1.04-1.15,P<0.01)及活产(OR=1.07,95%CI:1.03-1.11,P<0.01)正相关,与流产无显著相关性(P>0.05),不同EMT组间临床妊娠率及活产率差异显著(P<0.05),流产率差异不显著(P>0.05)。囊胚期移植时,多元Logistic回归显示EMT与临床妊娠、活产及流产均无显著相关性(P>0.05),不同EMT组间三种妊娠结局均无显著差异(P>0.05)。ROC曲线分析结果显示,EMT对新鲜周期胚胎移植妊娠结局的预测能力欠佳。结论:胚胎移植日EMT增加有助于改善妊娠结局,尤其应重点关注卵裂期胚胎移植受试者的EMT。Objective:To investigate the impact of endometrial thickness(EMT)on clinical pregnancy,live birth,and miscarriage rates in fresh embryo transfer cycles,as well as its predictive value.Method:A total of 2119 participants undergoing in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)from 2019 to 2022 were included.Logistic regression analysis was performed to assess the correlation between EMT and pregnancy outcomes.Participants were classified into five groups based on EMT on the day of embryo transfer:<9mm,9-11mm,11-13mm,13-15mm,and≥15mm.Baseline characteristics and pregnancy outcomes among the five groups were compared.Subgroup analyses explored the impact of different embryo transfer stages on the relationship between EMT and pregnancy outcomes.The predictive value of EMT for pregnancy outcomes in fresh embryo transfer cycles was analyzed by receiver operating characteristic(ROC)curve.Results:Multivariable logistic regression analysis revealed a significant positive correlation between EMT and clinical pregnancy(OR=1.06,95%CI:1.03-1.10,P<0.01)and live birth(OR=1.07,95%CI:1.03-1.11,P<0.01),while no significant association was found with miscarriage rates(P>0.05).Comparisons among different EMT groups in fresh embryo transfer cycles demonstrated a significant increase in clinical pregnancy and live birth rates with rising EMT(P<0.05),while miscarriage rates showed no significant differences(P>0.05).Subgroup analyses indicated that in cleavage-stage transfers,multivariable logistic regression showed a positive correlation between EMT and clinical pregnancy(OR=1.09,95%CI:1.04-1.15,P<0.01)and live birth(OR=1.07,95%CI:1.03-1.11,P<0.01),with no significant correlation with miscarriage(P>0.05).Significant differences were observed in clinical pregnancy and live birth rates among different EMT groups(P<0.05),while miscarriage rates showed no significant differences(P>0.05).In blastocyst-stage transfers,multivariable logistic regression indicated no significant correlations between EMT and clinical pregna

关 键 词：子宫内膜厚度 辅助生殖 妊娠结局 预测价值 

分 类 号：R714.7[医药卫生—妇产科学]