摘要
目的:探讨HCG日血清雌二醇水平与MⅡ期成熟卵母细胞数(E2/MⅡ)比值与体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)助孕结局的相关性。方法:回顾性分析754例于我中心采用GnRH激动剂降调节方案行IVF-ET助孕患者的周期临床资料,根据ROC曲线分析阈值以296为临界点将患者分为E2/MⅡ<296组(n=448)和E2/MⅡ≥296组(n=306),分析HCG日E2/MⅡ和患者的促排参数、胚胎参数及助孕结局的相关性。结果:ROC曲线分析显示,E2/MⅡ比值以296为临界点预测临床妊娠的敏感度为77.4%,特异度为64.1%(P<0.001)。E2/MⅡ<296组比E2/MⅡ≥296组患者的可用胚胎数、优质胚胎数多;且生化妊娠率和临床妊娠率均显著升高(P<0.001)。结论:HCG日E2/MⅡ比值可用于预测IVF周期的结局,HCG日E2/MⅡ<296可获得更多的可用胚胎和优质胚胎及更好的妊娠结局。对患者进行较温和的促排卵刺激,降低E2/MⅡ的比值可能会改善助孕的周期结局。
Objective To investigate the correlation between the serum estradiol/MⅡmature oocytes(E2/MⅡ)ratio on hCG trigger day and the pregnancy outcomes of in vitro fertilization-embryo transfer(IVF-ET).Methods The clinical data from 754 patients who underwent IVF-ET with a GnRH agonist protocol at the Reproductive Medicine Center,Renmin Hospital,Hubei University of Medicine were analyzed retrospectively.According to the ROC curve analysis,296 was estab-lished as the critical threshold,and the patients were divided into an E2/MⅡ<296 group(n=448)and an E2/MⅡ≥296 group(n=306).The correlations between the E2/MⅡratio and the patients′ovulation induction parameters,embryo parameters,and pregnancy outcomes were analyzed.Results The ROC curve analysis found that the E2/MⅡratio with a threshold of 296 had a sensitivity of 77.4%and a specificity of 64.1%for predicting clinical pregnancy(P<0.001).The number of available embryos and high-quality embryos in the E2/MⅡ<296 group was greater than those in the E2/MⅡ≥296 group.Additionally,the biochemical pregnancy rate and the clinical pregnancy rate in the E2/MⅡ<296 group were higher than those in the E2/MⅡ≥296 group(P<0.001).Conclusion The E2/MⅡratio on hCG trigger day can predict IVF cycle outcomes.An E2/MⅡratio<296 on hCG trigger day can yield more available and high-quality embryos and result in better pregnancy outcomes.It can improve the pregnancy outcomes by implementing mild induction protocols and lowering the E2/MⅡratio.
作者
徐少元
田佳榕
王玺
李欣
陈鑫
强灿灿
XU Shaoyuan;TIAN Jia-rong;WANG Xi;LI Xin;CHEN Xin;QIANG Can-can(Reproductive Medicine Center,Renmin Hospital,Hubei University of Medicine;Hubei clinical research center for reproductive medicine;Department of Cardiology,Renmin Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China)
出处
《湖北医药学院学报》
2025年第4期446-451,共6页
Journal of Hubei University of Medicine
基金
湖北省自然科学基金联合基金项目(2025AFD199)。
