补体C3水平对冻融胚胎移植妊娠结局的早期预测价值

doi:10.3969/j.issn.1006-5725.2024.07.008

Abstract

Abstract:

Objective To investigate the role of complement C3 in early predicting pregnancy outcomes of frozen-thawed embryo transfer （F-ET）. Methods A total of 378 F-ET cycles were prospectively collected and divided into group A （complement C3 ≤ 1.05， 120 cycles） and group B （complement C3 > 1.05， 258 cycles） based on the best cutoff value of complement C3 for predicting F-ET pregnancy outcomes. The outcomes of the two groups were compared， and the best cutoff value of complement C3 for predicting F-ET spontaneous abortion was analyzed in group B. Results Age was a risk factor for successful F-ET pregnancy （P < 0.05）， and complement C3 and embryo type were protective factors for successful F-ET pregnancy （P < 0.05）. The area under the receiver-operating characteristic curve （ROC） of complement C3 for predicting F-ET pregnancy outcome was 0.702， and the best cutoff value was 1.05 g/L， with a clinical pregnancy sensitivity of 87.60% and a specificity of 52.00%. The clinical pregnancy rate and embryo implantation rate in group B were both significantly higher than those in group A （67.05% vs. 52.75%， P < 0.05）. The best cutoff value of complement C3 for predicting spontaneous abortion after F-ET was 1.32 g/L， with an area under the ROC curve of 0.760， a sensitivity of 69.00%， and a specificity of 81.20%. Conclusions Complement C3 is of significance in the early prediction of F-ET pregnancy outcome. When complement C3 exceeds the level of 1.32 g/L， it may lead to an increase in the rate of spontaneous abortion.

Key words: frozen embryo transfer, clinical pregnancy rate, complement C3

CLC Number:

R711.6

Zhixia TANG,Shuangying MA,Ying ZHAGN,Jiajia SHENG,Juan LI,Jingjing HE,Henghua XUAN,Mingyun. HONG. Role of complement C3 in early predicting pregnancy outcomes of frozen⁃thawed embryo transfer[J]. The Journal of Practical Medicine, 2024, 40(7): 924-929.

Figures/Tables 6

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References 24

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常量	B	SE	Wald	自由度	P值	OR值	95%CI
年龄	-0.079	0.024	11.199	1	0.001	0.924	0.882 ~ 0.968
不孕类型	-0.326	0.210	2.415	1	0.120	0.722	0.478 ~ 1.089
不孕年限	-0.084	0.042	4.053	1	0.044	0.919	0.847 ~ 0.998
体重指数	-0.047	0.034	1.866	1	0.172	0.955	0.893 ~ 1.020
补体C3	4.221	0.657	41.304	1	< 0.001	68.100	18.797 ~ 246.713
补体C4	-1.339	1.156	1.341	1	0.247	0.262	0.027 ~ 2.528
TSH	0.121	0.100	1.440	1	0.230	1.128	0.927 ~ 1.373
CA125	-0.013	0.015	0.768	1	0.381	0.987	0.959 ~ 1.016
空腹血糖	0.092	0.241	0.145	1	0.703	1.096	0.683 ~ 1.758
周期类型	-0.320	0.309	1.072	1	0.300	0.726	0.396 ~ 1.331
子宫内膜厚度	-0.014	0.049	0.082	1	0.774	0.986	0.896 ~ 1.085
移植胚胎数	0.144	0.211	0.465	1	0.495	1.155	0.764 ~ 1.746
受精类型	-0.074	0.228	0.106	1	0.744	0.928	0.594 ~ 1.451
胚胎类型	0.818	0.212	14.830	1	< 0.001	2.265	1.494 ~ 3.434

常量	B	SE	Wald	自由度	P值	OR值	95%CI
胚胎类型	0.793	0.236	11.283	1	0.001	2.210	1.391 ~ 3.511
年龄	-0.056	0.026	4.454	1	0.035	0.946	0.898 ~ 0.996
不孕年限	-0.087	0.048	3.227	1	0.072	0.917	0.843 ~ 1.008
补体C3	4.429	0.688	41.492	1	< 0.001	83.812	21.782 ~ 322.495

组别	A组	B组	t/Z/χ²值	P值
周期数（个）	120	258
年龄（岁）	33.14 ± 4.49	32.16 ± 4.54	1.959	0.051
体质量指数（kg/m²）	22.25 ± 3.18	22.90 ± 2.97	-1.932	0.054
补体C4（g/L）	0.26 ± 0.09	0.27 ± 0.10	-0.267	0.790
促甲状腺激素（μIU/mL）	2.20 ± 0.99	2.26 ± 1.06	-0.500	0.617
空腹血糖（mmol/l）	5.18 ± 0.42	5.23 ± 0.43	-1.070	0.285
CA125［M（P₂₅，P₇₅），ng/mL］	9.85（6.55，15.23）	11.90（7.68，16.33）	-1.765	0.078
不孕年限［M（P₂₅，P₇₅），年］	2.5（1.00，4.75）	2.00（1.75，4.00）	-0.062	0.950
不孕类型［例（%）］			0.116	0.733
原发性不孕	52（43.33）	107（41.47）
继发性不孕	68（56.67）	151（58.53）
子宫内膜厚度（mm）	10.52 ± 2.14	10.61 ± 2.10	-0.385	0.700
移植胚胎数（个）	1.37 ± 0.48	1.41 ± 0.49	-0.816	0.415
周期类型［例（%）］			0.135	0.713
自然周期	17（14.17）	33（12.79）
替代周期	103（85.83）	225（87.21）
受精类型［例（%）］			0.313	0.576
IVF	88（73.33）	182（70.54）
ICSI	32（26.67）	76（29.46）
胚胎类型［例（%）］			0.417	0.519
卵裂期	54（45.00）	107（41.47）
囊胚期	66（55.00）	151（58.53）

项目	A组	B组	χ²值	P值
临床妊娠率	28（23.33）	173（67.05）	62.879	< 0.001
胚胎着床率	34/164（20.73）	192/364（52.75）	47.335	< 0.001
流产率	3（10.71）	29（16.76）	0.284	0.954

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Role of complement C3 in early predicting pregnancy outcomes of frozen⁃thawed embryo transfer

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