冷冻单囊胚移植术后14天血清β-hCG浓度与妊娠结局的关系
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摘要
目的研究冷冻单囊胚移植术后第14天血清в-hCG浓度对临床结局的预测性。方法回顾性分析2013年1月1日至2017年12月31日1078例冷冻单囊胚复苏移植术后患者,分析其移植术后第14天的血清в-hCG水平。根据ROC曲线计算血清в-hCG对临床妊娠、异位妊娠和早期流产切割值及预测性。结果冷冻单囊胚复苏移植术后患者临床妊娠血清в-hCG的截断值为629.5U/L(灵敏度91.10%,特异度99.90%),诊断准确性为91.65%。异位妊娠截断值为1071.5U/L(灵敏度82.00%,特异度99.90%),诊断准确性为84.31%。早期流产的截断值为1196.5U/L(灵敏度为81.60%,特异度为47.80%)。诊断准确性为82.16%。结论移植术后第14天血清в-hCG值可以作为冷冻单囊胚移植早期妊娠结局良好的预测指标。
Objective:To investigate the role of serum в-hCG levels 14 days after transfer in predicting pregnancy outcome after single frozen-thawed blastocyst transfer. Methods:A retrospective study was performed in 1078 single frozen-thawed blastocyst transfer cycles between 1 st January,2013 to 31 th December,2017. The level of serum в-hCG 14 days after transfer was evaluated. Cutoff values for discriminating clinical pregnancy,ectopic pregnancy and early abortion were determined using a Receiver operating characteristic curve analysis. Results:The cutoff value of serum в-hCG 14 days after single frozenthawed blastocyst transfer for clinical pregnancies were 629.5 U/L(sensitivity 91.10%,specificity99.90% and diagnostic accuracy91.65%). The cutoff value for ectopic pregnancy were 1071.5 U/L(sensitivity82.00%,specificity 99.90%,and diagnostic accuracy84.31%). The cutoff value for early abortion were 1196.5 U/L(sensitivity81.60%,specificity47.80% and diagnostic accuracy82.16%). Conclusion:The serum в-hCG level is a reliable predictive factor for predicting single frozenthawed blastocyst transfer outcomes
Objective:To investigate the role of serum в-hCG levels 14 days after transfer in predicting pregnancy outcome after single frozen-thawed blastocyst transfer. Methods:A retrospective study was performed in 1078 single frozen-thawed blastocyst transfer cycles between 1 st January,2013 to 31 th December,2017. The level of serum в-hCG 14 days after transfer was evaluated. Cutoff values for discriminating clinical pregnancy,ectopic pregnancy and early abortion were determined using a Receiver operating characteristic curve analysis. Results:The cutoff value of serum в-hCG 14 days after single frozenthawed blastocyst transfer for clinical pregnancies were 629.5 U/L(sensitivity 91.10%,specificity99.90% and diagnostic accuracy91.65%). The cutoff value for ectopic pregnancy were 1071.5 U/L(sensitivity82.00%,specificity 99.90%,and diagnostic accuracy84.31%). The cutoff value for early abortion were 1196.5 U/L(sensitivity81.60%,specificity47.80% and diagnostic accuracy82.16%). Conclusion:The serum в-hCG level is a reliable predictive factor for predicting single frozenthawed blastocyst transfer outcomes
引文
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[5]Sung Nayoung,Kwak-Kim Joanne,Koo H S,Yang K M.Serum hCG-βlevels of postovulatory day 12 and 14 with the sequential application of hCG-βfold change significantly increased predictability of pregnancy outcome after IVF-ET cycle[J].Journal of assisted reproduction and genetics,2016,33(9).
[6]Grin L,Indurski A,Leytes S,et al.Trends in primevalβ-hCGlevel increment after fresh and frozen-thawed IVF embryo transfer cycles[J].Gynecol Endocrinol,2018,10(9).
[7]孔娜,刘景瑜,王玢,孙海翔.移植术后第14天血清β-HCG对辅助生育妊娠结局的预测[J].生殖医学杂志,2015,24(9):727-731.
[8]郑中,赵晓明,孙赟,等.体外受精新鲜胚胎移植术后14d血清β-hCG浓度与妊娠结局的关系[J].生殖与避孕,2015,35(08):566-570.
[9]Restrepo H,Shapiro,BS,Garner,FC,et al.Serum HCG measured in the peri-implantation period predicts IVF cycle outcomes[J].Reproductive biomedicine online,2012,25(3):248-253.
[2]Galia Oron,Efrat Esh-Broder,Weon-Young Son,et al.Predictive value of maternal serum human chorionic gonadotropin levels in pregnancies achieved by in vitro fertilization with single cleavage and single blastocyst embryo transfers[J].Fertility and Sterility,2015,103(6).
[3]Banu Kumbak,Engin Oral,Guvenc Karlikaya,et al.Serum oestradiol andβ-HCG measurements after day 3 or 5 embryo transfers in interpreting pregnancy outcome[J].Reproductive BioMedicine Online,2006,13(4).
[4]赵伟娥,李玉洁,欧建平,等.Predictive Value of Initial Serum Human Chorionic Gonadotropin Levels for Pregnancies after Single Fresh and Frozen Blastocyst Transfer[J].Journal of Huazhong University of Science and Technology(Medical Sciences),2017,37(3):395-400.
[5]Sung Nayoung,Kwak-Kim Joanne,Koo H S,Yang K M.Serum hCG-βlevels of postovulatory day 12 and 14 with the sequential application of hCG-βfold change significantly increased predictability of pregnancy outcome after IVF-ET cycle[J].Journal of assisted reproduction and genetics,2016,33(9).
[6]Grin L,Indurski A,Leytes S,et al.Trends in primevalβ-hCGlevel increment after fresh and frozen-thawed IVF embryo transfer cycles[J].Gynecol Endocrinol,2018,10(9).
[7]孔娜,刘景瑜,王玢,孙海翔.移植术后第14天血清β-HCG对辅助生育妊娠结局的预测[J].生殖医学杂志,2015,24(9):727-731.
[8]郑中,赵晓明,孙赟,等.体外受精新鲜胚胎移植术后14d血清β-hCG浓度与妊娠结局的关系[J].生殖与避孕,2015,35(08):566-570.
[9]Restrepo H,Shapiro,BS,Garner,FC,et al.Serum HCG measured in the peri-implantation period predicts IVF cycle outcomes[J].Reproductive biomedicine online,2012,25(3):248-253.