IVF-ET 过程中流产因素分析.docVIP

天津医药 2012 年 7 月 第 40 卷 第 7 期 doi:10.3969/j.issn.0253-9896.2012.07.007 IVF-ET 过程中流产因素分析  663 王俊超 徐凤琴 罗海宁 马俊芳 张云山  摘要 12 月行 IVF-ET 且成功临床妊娠的患者 1 195 例，其中流产患者 203 例，包括早期流产患者 150 例，为 A 组；晚期流产患 者 53 例，为 B 组；持续妊娠及分娩患者 992 例，为 C 组。分别对 3 组患者年龄、体质量指数（BMI）、超排卵（COH）情况、 临床妊娠情况及是否行减胎等治疗进行比较和分析。结果：A 组患者年龄、促性腺激素（Gn）总量明显高于 C 组；B 组 BMI 明显高于 A 组、C 组。A 组 ET 后第 14 天β-hCG 水平明显低于 B 组、C 组而单胎妊娠率明显高于 B、C 两组，B 组胎儿 畸形率、减胎率明显高于 A 组、C 组。3 组患者注射 hCG 日发育卵泡数、获卵数、雌二醇水平及受精方式差异无统计学 意义。结论：高 BMI、大剂量 Gn 超排卵以及多胎妊娠和减胎术是 IVF-ET 时造成流产的重要因素，ET 后 14 d 血β-hCG 水平偏低提示胚胎发育不良、早期流产的风险大。 关键词 受精，体外 胚胎移植 流产 促性腺素类 雌二醇 排卵  Analysis of Abortion during IVF-ET Treatment WANG Junchao, XU Fengqin, LUO Haining, MA Junfang, ZHANG Yunshan Tianjin Center Obstetrics and Gynecology Hospital, Tianjin 300100, China Abstract Methods: Two hundred and three patients including 150 patients with early abortion (group A) and 53 patients with late abor? tion (group B) were enrolled, while 992 patients with continuing pregnancy and full-term pregnancy were as control (group C). The age, body mass index (BMI), hyperstimulation (COH) and clinical pregnancy results were compared between three groups. Results: The age, total dosage of gonadotropin (Gn) and the single pregnancy rate were significantly higher in group A than those in group B and group C. The value of BMI was higher in group B than that of group A and group C. The level of β-hCG was lower in group A 14 days after ET treatment than that of group B and group C, but the pregnancy rate was significantly higher in group A than that of group B and group C. Rates of fetal malformation and fetal reduction were significantly higher in group B than those in group A and group C. There were no significant differences in numbers of follicle development and egg retrieval, type of insemination and the estradiol level on the day of hCG injection between three groups. Conclusion: In? creasing BMI and large dose of Gn during COH can influence the receptivity of the endometrium and the e