摘要
目的探讨体外受精-胚胎移植(IVF-ET)妊娠后发生妊娠丢失的相关因素。方法收集2018年1月至2019年1月于本院接受IVF-ET后妊娠的286例患者作为研究对象,根据妊娠状况分为妊娠丢失组(A组)(78例)及妊娠持续组(B组)(208例),统计286例患者的年龄、不育年限、体质量指数(BMI)、既往流产史、获卵数量、取卵日子宫内膜厚度、子宫解剖结构是否异常、不孕原因(原发不孕、继发不孕)、胚胎染色体异常,检测妊娠前3个月患者的免疫相关指标及凝血指标,包括蛋白S(Ps)、蛋白C(Pc)、抗凝血酶Ⅲ(AT-Ⅲ)、同型半胱氨酸(tHcy)、血小板聚集率。结果A组患者年龄明显长于B组,BMI水平明显高于B组,有既往流产史人数所占比例明显高于B组,胚胎染色体异常率高于B组(P<0.05);A组患者的Ps、Pc、AT-Ⅲ水平明显低于B组,tHcy水平明显高于B组(P<0.05);Logistic多因素回归分析显示,年龄、BMI、既往流产史、胚胎染色体异常、Ps、Pc、AT-Ⅲ以及tHcy均是IVF-ET后发生妊娠丢失的独立危险因素(P<0.05)。结论年龄过大、肥胖、既往流产史、胚胎染色体异常、Ps、Pc、AT-Ⅲ以及tHcy水平异常均是导致IVF-ET后发生妊娠丢失的主要影响因素,针对高危患者应在进行辅助生殖治疗前尽早进行相应治疗,以减少妊娠丢失。
Objective To explore the related factors of pregnancy loss after in vitro fertilization-embryo transfer(IVF-ET).Methods A total of 286 pregnant women who underwent IVF-ET in our hospital from January 2018 to January 2019 were selected as subjects.According to the status of pregnancy,the subjects were divided into pregnancy loss group(group A)(78 cases)and continuing pregnancy group(group B)(208 cases).Age,years of infertility,body mass index(BMI),previous history of abortion,number of obtained ova,endometrial thickness on the day of ovum retrieval,uterine anatomical structure,causes of infertility(primary infertility,secondary infertility),and embryonic chromosome abnormalities of the 286 patients were statistically analyzed.The immune-related indexes and coagulation indexes,including protein S(Ps),protein C(Pc),antithrombin III(AT-III),homocysteine(tHcy),and platelet aggregation rate were detected at 3 months before pregnancy.Results Patients in group A were significantly older than group B,BMI was significantly larger than that in group B,the proportion of patients with previous history of abortion was significantly higher than that in group B,and the rate of embryonic chromosome abnormalities was higher than that in group B(P<0.05).The levels of Ps,Pc,ATIII in group A were significantly lower than those in group B,the level of tHcy was higher than that in group B(P<0.05).Multivariate Logistic regression analysis showed that age,BMI,previous history of abortion,embryonic chromosome abnormalities,Ps,Pc,AT-III,and tHcy were independent risk factors for pregnancy loss after IVFET(P<0.05).Conclusion High age,obesity,previous history of abortion,embryonic chromosome abnormalities,abnormal levels of Ps,Pc,AT-III,and tHcy are main factors influencing pregnancy loss after IVF-ET.Corresponding treatment should be carried out among high-risk patients before conducting assisted reproductive therapy as soon as possible to reduce pregnancy loss.
作者
王韵一
Wang Yunyi(Department of Reproductive Medicine,Nanyang First People's Hospital,Nanyang 473010,China)
出处
《国际医药卫生导报》
2019年第20期3413-3416,共4页
International Medicine and Health Guidance News
关键词
体外受精-胚胎移植
妊娠丢失
相关因素
In vitro fertilization-embryo transfer
Pregnancy loss
Related factor
