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目的探讨IVF-ET助孕治疗中新鲜周期移植不孕而后续的冷冻周期成功妊娠的原因以指导治疗。方法回顾性分析体外受精或单精子卵母细胞浆内注射-胚胎移植术(IVF/ICSI-ET)治疗患者950个周期,其中新鲜周期妊娠组780个周期和新鲜周期未孕冷冻周期妊娠组170个周期,比较两组患者年龄、不孕年限、病因及基础FSH水平、Gn使用情况、hCG日内膜、激素水平、卵泡数、获卵及胚胎情况的差异。采用单因素分析筛选出差异有统计学意义的因素进行多因素分析。结果经Logistic回归分析得出hCG日P4、hCG日E2/1000是妊娠的独立影响因素。hCG日P4(OR=1.653,P=0.015,95%CI:1.101～2.482),hCG日E2/1000(OR=1.219,P=0.001,95%CI:1.085～1.369)。hCG日酮孕每增加1ng/ml,新鲜周期不孕而冷冻周期妊娠的风险将增加1.653倍。hCG日E2每增加1000pg/ml,新鲜周期不孕而冷冻周期妊娠的风险将增加1.219倍。结论 hCG日的P4和E2是导致新鲜移植不孕而冷冻周期妊娠的重要原因。P4和E2过高,可考虑放弃新鲜移植,采用冷冻移植。
Objective To investigate the causes of successful pregnancy after IVF-ET assisted pregnancy with fresh-cycle implanted infertility and follow-up cryosurgery to guide the treatment. Methods A total of 950 cycles of in vitro fertilization or IVF / ICSI-ET were retrospectively analyzed. Among them, 780 cycles of fresh-cycle pregnancy and fresh-cycle non-frozen stage of pregnancy were 170 The differences of age, duration of infertility, etiology, basal FSH level, Gn use, intra-day hCG, hormone level, number of follicles, ovum and embryo were compared between two groups. Univariate analysis was used to screen out the difference statistically significant factors for multivariate analysis. Results Logistic regression analysis showed that hCG day P4, hCG day E2 / 1000 were independent influencing factors of pregnancy. hCG day P4 (OR = 1.653, P = 0.015, 95% CI: 1.101-2.482) and E2 / 1000 on hCG day (OR = 1.219, P = 0.001, 95% CI: 1.085-1.369). hCG daily dose of 1ng / ml uridone pregnancy, fresh cycle of infertility and frozen-cycle pregnancy will increase the risk of 1.653 times. For each 1000 pg / ml increase in hCG daily E2, the risk of frozen-period pregnancies will increase 1.219-fold with fresh-period infertility. Conclusions P4 and E2 on hCG day are the important causes of frozen pregnancy. P4 and E2 too high, consider giving up the new transplant, the use of frozen transplants.