摘要
目的:探讨体外受精-胚胎移植(IVF-ET)技术中胚胎培养液人绒毛膜促性腺激素(HCG)、可溶性人类白细胞分化抗原-G(sHLA-G)水平与术后临床妊娠的相关性。方法:.选取2018年2月-2020年5月120例在上海市第一妇婴保健院行IVF-ET助孕临床资料进行回顾性分析,移植胚胎数均2枚。根据助孕后临床妊娠分为妊娠组(成功妊娠)与非妊娠组(妊娠失败)各60例。采用logistic回归模型分析影响IVF-ET助孕后妊娠结局的危险因素,Spearman法分析HLA-G、HCG与妊娠结局、优胚数的相关性,运用受术者工作特征曲线(ROC)分析HLA-G、HCG预测妊娠结局效能。结果:妊娠组与非妊娠组在年龄、授精方式、不孕时间、基础性激素水平、Gn天数、Gn总量、内膜厚度、获卵数、授精数、胚胎数等比较均无差异(P>0.05);培养液中HCG、sHLA-G、优胚数妊娠组均高于非妊娠组(均P<0.05)。多因素logistic回归分析显示,sHLA-G、HCG、优胚数是影响行IVF-ET助孕后妊娠的独立危险因素(P<0.05);Spearman相关性分析,sHLA-G、HCG与IVF-ET助孕妊娠(r=0.559、0.682,均P<0.05)及优胚数(r=0.602、0.564,均P<0.05)均呈正相关;ROC曲线分析显示,HCG、sHLA-G预测临床妊娠的曲线下面积分别为0.823、0.894,HCG最佳临界值1.29IU/L,敏感度为66.7%,特异度85.0%。约登指数0.517;sHLA-G最佳临界值4.73 IU/ml,敏感度78.3%,特异度为90.0%,约登指数0.683。结论:辅助生殖技术时胚胎培养液中HCG、sHLA-G水平与早期胚胎发育及临床妊娠有一定相关性,可将其作为预测助孕妊娠的重要参考评估指标。
Objective:To investigate the correlation between the levels of human chorionic gonadotropin(HCG)and soluble human leukocyte differentiation antigen-C(sHLA-G)in embryo culture medium of women during in vitro fertilization-embryo transfer(IVF-ET)and their clinical pregnancy after assisted reproduction.Methods:The clinical data of 120 women who were being treated for infertility and underwent IVF-ET from February 2018 to May 2020 were analyzed retrospectively.Two embryos were transferred for each of 120 patients in every IVF-ET cycle.According to the clinical pregnant situation,120 woen were divided into group A(60 women with successful pregnancy)and group B(60 women with pregnancy failure).Logistic regression model was used to analyze the risk factors affecting pregnancy of the women after IVF-ET.Spearman method was used to analyze the correlation between the HLA-G and HCG levels of the women and their pregnancy and the number of excellent embryos.Receiver operating characteristic curve(ROC)curve was used to analyze the efficacy of the levels of HLA-G and HCG of the women for predicting their pregnancy outcomes.Results:There were no significant differences in age,insemination method,infertility time,basal sex hormone level,Gn days,Gn total dosage,endometrial thickness,number of oocytes obtained,number of fertilization eggs,and number of embryos of the women between the two groups(P>0.05).The levels of HCG and SHLA-G in embryo culture medium and number of good embryos of the women in group A were significantly higher than those of the women in group B(all P<0.05).Multivariate logistic regression analysis showed that the SHLA-G and HCG levels,and the number of good embryos of the women after IVF-ET were the independent risk factors of their pregnancy(P<0.05).Spearman correlation analysis showed that the SHLA-G and HCG levels of the women were positively correlated with their pregnancy after IVF-ET(r=0.559,0.682,all P<0.05)and their number of good embryos(r=0.602,0.564,all P<0.05).ROC curve analysis showed that the area under the curve of HCG level and SHLA-G level for predicting clinical pregnancy were 0.823 and 0.894,respectively.The optimal cut-off value,the sensitivity,the specificity,and Youden index of HCG level for predicting clinical pregnancy were 1.29IU/L,66.7%,85.0%,and 0.517,respectively.The optimal cut-off value,the sensitivity,the specificity,and Youden index of SHLA-G level for predicting clinical pregnancy were 4.73 IU/ml,78.3%,90.0%,and 0.683,respectively.Conclusion:The levels of HCG and sHLA-G in embryo culture medium of the women after assisted reproduction have certain correlation with their early embryo development and clinical pregnancy,and which can be used as the important reference indicators for predicting pregnancy of the women after assisted reproduction.
作者
张艳琼
李阳
王建华
张平武
陈虹
ZHANG Yanqiong;LI Yang;WANG Jianhua;ZHANG Pingwu;CHEN Hong(Meishan City People’s Hospital,Meishan,Sichuan Province,620010;Shanghai First Maternity and Infant Hospital,Shanghai)
出处
《中国计划生育学杂志》
2022年第9期1972-1976,共5页
Chinese Journal of Family Planning
关键词
体外受精-胚胎移植
胚胎培养液
人绒毛膜促性腺激素
可溶性人类白细胞分化抗原-C
临床妊娠
预测
In vitro fertilization-embryo transfer
Embryo culture medium
Human chorionic gonadotropin
Soluble human leukocyte differentiation antigen-C
Clinical pregnancy
Prediction
