实用医学杂志 ›› 2021, Vol. 37 ›› Issue (13): 1690-1694.doi: 10.3969/j.issn.1006⁃5725.2021.13.009

• 临床研究 • 上一篇    下一篇

hCG日孕酮过高或过低对年轻累积活产率的影响全胚冷冻患者周期

詹少泉1,郑海燕2, 曹明珠1, 刘见桥1, 毛玉玲1, 龙晓林1, 刘寒艳1    

  1. 1 广州医科大学附属第三医院妇产科,生殖医学中心,广东省产科重大疾病重点实验室,广东省生殖医学 重点实验室(广州 510150);2 浙江大学医学院附属第一医院生殖医学中心(杭州 310003)

  • 出版日期:2021-07-10 发布日期:2021-07-10
  • 通讯作者: 刘寒艳 E⁃mail:liuhanyan21@gzhmu.edu.cn
  • 基金资助:
    国家自然科学基金(编号:81701400)

Effect of low or high progesterone level in hCG day in embryo quality,and cumulative live birth rate in freeze-all strategy patients 

ZHAN Shaoquan,ZHENG Haiyan,CAO Mingzhu,LIU Jianqiao,MAO Yuling, LONG Xiaolin,LIU Hanyan.    

  1. Department of Obstetrics and Gynecology,Center for Reproductive Medicine,Key Lab⁃ oratory for Major Obstetric Diseases of Guangdong Province,Key Laboratory for Reproductive Medicine of Guang⁃ dong Province,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China 

  • Online:2021-07-10 Published:2021-07-10
  • Contact: LIU Hanyan E⁃mail:liuhanyan21@gzhmu.edu.cn

摘要:

目的 探讨新鲜周期 hCG 日孕酮(P4)水平对全胚冷冻周期累积活产率的影响。方法 顾性分析 2016 1 月至 2018 12 月本中心行 IVF 1 周期治疗的≤ 35 岁使用拮抗剂或者激动剂方案的 全胚冷冻患者资料,按 hCG 日孕酮水平分为四组:组 1(< 0.50 ng/mL,n = 801),组 2(0.50 ~ 1.14 ng/mL n = 1626),组 3(1.15 ~ 1.49 ng/mL,n = 499)和组 4(≥ 1.50 ng/mL,n = 997),其中以组 2 为对照组。结果 与对照组相比,组 1 优质胚胎率和冷冻胚胎率显著增加(P < 0.01),组 4 优质胚胎率、冷冻胚胎率显著下降 P < 0.01)。累积活产率组 4 显著低于对照组(69.71% vs. 75.83%,P < 0.001),其他各组差异无统计学意 义。经多因素回归分析显示,与对照组相比,组 4 累积活产率显著降低(AOR = 0.759,95%CI:0.63 ~ 0.91 P < 0.01);组 1 不会影响全冻周期累积活产率(AOR = 0.901,95%CI:0.74 ~ 1.10,P > 0.05)。结论 hCG P4 ≥ 1.5 ng/mL 显著降低累积活产率,可能与优质胚胎率,冷冻胚胎率下降有关;P4 < 0.5 ng/mL 不会影响胚 胎质量,也不会影响全胚冷冻周期的累积活产率。

关键词:

孕酮, 胚胎质量, 全胚冷冻, 活产, 累积活产 ,

Abstract:

Objective To explore the effect of progesterone(P4)level on hCG day on embryo quality and cumulative live birth rate in freeze⁃all strategy patients. Methods From January 2016 to December 2018 patients under 36 years old with first IVF cycle,antagonist or agonist protocol in freeze⁃all strategy were retrospec⁃ tively analyzed and divided into four groups according to their hCG ⁃day P4 levels:group 1(< 0.50 ng/mL,n = 801),group 2(0.50 ~ 1.14 ng/mL,n = 1 626),group 3(1.15 ~ 1.49 ng/mL,n = 499)and group 4(≥ 1.50 ng/mL n = 997). The control group was group 2. Results Compared with the control group,the rate of high⁃quality em⁃ bryos and frozen embryos in group 1 increased significantly(P < 0.01),while that in group 4 decreased significantly (P < 0.01). The cumulative live rate in group 4 were significantly lower than those in the control group(69.71% vs. 75.83%,P < 0.001). Multivariate regression analysis showed that group 4 significantly reduced the cumulative live birth rate(AOR = 0.759,95%CI:0.63 ~ 0.91,P < 0.01);group 1 did not affect the cumulative live birth rate(AOR = 0.901,95%CI:0.74 ~ 1.10,P > 0.05). Conclusion P4 level ≥ 1.5 ng/mL on hCG day significantly reduced the cumulative live rate,which may relate to the decrease of the high ⁃quality embryo rate and frozen embryo rate;P4 level < 0.5 ng/mL did not affect embryo quality and cumulative live birth rate in freeze⁃all strategy cycles.

Key words:

progesterone, embryo quality, freeze?all strategy, live birth, cumulative live birth