不孕症患者冻胚移植周期中移植日血清雌二醇水平对妊娠结局的影响  

Effect of estrogen levels on the day of embryo transfer in FET cycle on pregnancy outcome in patients with infertility

作　　者：张文燕 姜波 李晓荣[1,2] 冯亚宏 王钦娇 秦岭 仲佳雯 ZHANG Wenyan;JIANG Bo;LI Xiaorong;FENG Yahong;WANG Qinjiao;QIN Ling;ZHONG Jiawen(Reproductive Center,General Hospital of Ningxia Medical University,Yinchuan 750004,China;不详)

机构地区：[1]宁夏医科大学总医院生殖中心,宁夏银川750004 [2]宁夏医科大学中医学院,宁夏银川750003 [3]宁夏中医医院暨中医研究院妇科,宁夏银川750021

出　　处：《山东医药》2025年第3期17-21,共5页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(82260947);宁夏回族自治区自然科学基金资助项目(2023AAC05059)。

摘　　要：目的分析不孕症患者冻胚移植(FET)周期中移植日血清雌二醇(E_(2))水平对妊娠结局的影响。方法选择接受FET助孕且内膜准备方案为激素替代周期(HRT)的不孕症患者323例,根据移植日血清E_(2)水平将其分为A组45例(移植日血清E_(2)<100 pg/mL)、B组187例(移植日血清E_(2)为100~300 pg/mL)和C组91例(移植日血清E_(2)>300 pg/mL)。比较三组的妊娠结局相关指标,包括临床妊娠率、生化妊娠率、早期流产率、多胎妊娠率和活产率。采用多因素Logistic回归分析移植日血清E_(2)对妊娠结局(临床妊娠、活产)的影响。结果A、B、C组临床妊娠率分别为33.3%、41.7%、26.4%,活产率分别为73.3%、78.2%、62.5%,B组>A组>C组(P均<0.05)。A、B、C组生化妊娠率、早期流产率、多胎妊娠率比较差异均无统计学意义(P均>0.05)。323例不孕症患者FET后临床妊娠117例、未妊娠206例,临床妊娠者移植日血清E_(2)水平低于未妊娠者(P<0.05),且移植日血清E_(2)水平过高是影响不孕症患者FET后临床妊娠的独立危险因素[P=0.009,OR(95%CI):0.996(0.993~0.999)]。117例FET后临床妊娠的不孕症患者活产87例、未活产30例,活产者移植日血清E_(2)水平低于未活产者(P<0.05),且移植日血清E_(2)水平过高是影响FET后临床妊娠的不孕症患者活产的独立危险因素[P=0.024,OR(95%CI):0.997(0.994~0.999)]。结论FET周期中移植日血清E_(2)水平为100~300 pg/mL的不孕症患者临床妊娠率和活产率较高,移植日血清E_(2)水平过高不利于临床妊娠及妊娠后活产。Objective To analyze the effect of estradiol(E_(2))levels on the day of embryo transfer in the frozen embryo transfer(FET)cycle on pregnancy outcomes in infertile patients.Methods Totally 323 infertile patients who received FET and had endometrial preparation with hormone replacement therapy(HRT)were divided into three groups based on E_(2) levels on the day of embryo transfer:Group A(n=45,E_(2)<100 pg/mL),Group B(n=187,E_(2)100-300 pg/mL),and Group C(n=91,E_(2)>300 pg/mL).The pregnancy outcome-related indicators,including clinical pregnancy rate,biochemical pregnancy rate,early miscarriage rate,multiple pregnancy rate,and live birth rate,were compared among the three groups.Multivariate Logistic regression was used to analyze the effect of E_(2) on the day of embryo transfer on pregnancy outcomes(clinical pregnancy and live birth).Results The clinical pregnancy rates in the Groups A,B,and C were 33.3%,41.7%,and 26.4%,respectively,and the live birth rates were 73.3%,78.2%,and 62.5%,respectively,with Group B>Group A>Group C(all P<0.05).There were no statistically significant differences in biochemical pregnancy rate,early miscarriage rate,or multiple pregnancy rate among the three groups(all P>0.05).Among the 323 infertile patients,117 achieved clinical pregnancy and 206 did not.The E_(2) level on the day of embryo transfer was lower in those who achieved clinical pregnancy than in those who did not,and E_(2) was an independent risk factor for clinical pregnancy after FET in infertile patients[P=0.009,OR(95%CI):0.996(0.993~0.999)].Among the 117 infertile patients who achieved clinical pregnancy after FET,87 had live births and 30 did not.The E_(2) level on the day of embryo transfer was lower in those who had live births than in those who did not,and excessively high E_(2) on the day of embryo transfer was an independent risk factor for live birth in infertile patients who achieved clinical pregnancy after FET[P=0.024,OR(95%CI):0.997(0.994~0.999)].Conclusion Infertile patients with E_(2) levels of 100-300 pg/mL on

关 键 词：雌二醇 移植日 冻胚移植 妊娠结局 不孕症 

分 类 号：R717[医药卫生—妇产科学]