摘要
目的:分析卵巢子宫内膜异位囊肿(OEM)不孕患者体外受精-胚胎移植(IVF-ET)后早期流产的影响因素,并构建风险预测模型。方法:回顾性分析2022年1月至2025年2月于洛阳市中心医院就诊的142例OEM不孕患者的临床资料,所有患者IVF-ET后均成功妊娠,根据是否发生早期流产分为发生组(20例)与未发生组(122例)。比较两组患者的临床资料,分析IVF-ET后早期流产的影响因素,在此基础上构建风险预测模型并评价其预测效能。结果:两组患者助孕前体质量指数(BMI)、不同宫腔操作史占比、基础雌二醇水平、胚胎移植14 d时β-人绒毛膜促性腺激素(β-HCG)水平比较,差异具有统计学意义(P<0.05);多因素Logistic回归分析结果显示,助孕前BMI<18.5 kg·m^(-2)、助孕前BMI>24.0 kg·m^(-2)、宫腔操作史> 1次、基础雌二醇及胚胎移植14 d时β-HCG水平下降是OEM不孕患者IVF-ET后早期流产的危险因素(P<0.05);基于上述指标,构建OEM不孕患者IVF-ET后早期流产的风险预测模型,校正曲线提示模型区分度良好,曲线下面积(AUC)为0.918,95%CI为0.869~0.966。结论:助孕前BMI<18.5 kg·m^(-2)、助孕前BMI>24.0 kg·m^(-2)、宫腔操作史> 1次、基础雌二醇及胚胎移植14 d时β-HCG水平下降是OEM不孕患者IVF-ET后早期流产的危险因素,基于其构建的列线图模型在预测OEM不孕患者IVF-ET后早期流产中的价值高。
Objective To analyze the influencing factors of early miscarriage after in vitro fertilization-embryo transfer(IVF-ET)in infertile patients with ovarian endometriomas(OEM)and to construct a risk prediction model.Methods The clinical data of 142 infertile patients with OEM who were treated at Luoyang Central Hospital from January 2022 to February 2025 were retrospectively analyzed.All patients successfully conceived after IVF-ET and were divided into an occurrence group(20 cases)and a non-occurrence group(122 cases)based on whether early miscarriage occurred.The clinical data of the two groups were compared to analyze the influencing factors of early miscarriage after IVF-ET.On this basis,a risk prediction model was constructed and its predictive efficacy was evaluated.Results There were statistically significant differences in pre-assisted reproductive technology body mass index(BMI),proportion of operations different uterine cavity histories,basal estradiol level,andβ-human chorionic gonadotropin(β-HCG)level 14 days after embryo transfer between the two groups(P<0.05).Multivariate Logistic regression analysis showed that pre-assisted reproductive technology BMI<18.5 kg·m^(-2),pre-assisted reproductive technology BMI>24.0 kg·m^(-2),history of uterine cavity operation>1 time,and decreasedβ-HCG level 14 days after embryo transfer were risk factors for early miscarriage after IVF-ET in infertile patients with OEM(P<0.05).Based on the above indicators,a risk prediction model for early miscarriage after IVF-ET in infertile patients with OEM was constructed.The calibration curve indicated that the model had good discrimination,and the area under the curve(AUC)was 0.918,95%CI:0.869-0.966.Conclusion Pre-assisted reproductive technology BMI<18.5 kg·m^(-2),pre-assisted reproductive technology BMI>24.0 kg·m^(-2),history of uterine cavity operation>1 time,and decreasedβ-HCG level 14 days after embryo transfer are risk factors for early miscarriage after IVF-ET in infertile patients with OEM.The nomogram model constructed based on these factors has high value in predicting early miscarriage after IVF-ET in infertile patients with OEM.
作者
周瑶
杨晓亮
陈莹
ZHOU Yao;YANG Xiaoliang;CHEN Ying(Department of Reproductive Medicine,Luoyang Central Hospital,Henan Luoyang 471000)
出处
《深圳中西医结合杂志》
2025年第22期18-22,I0006,共6页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
卵巢子宫内膜异位囊肿不孕
体外受精-胚胎移植
早期流产
风险预测模型构建
Infertility with ovarian endometriomas
In vitro fertilization-embryo transfer
Early miscarriage
Risk prediction model construction
