中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2014年
10期
763-767
,共5页
曾湘晖%王莉云%舒晓巍%熊正芳%党小红
曾湘暉%王莉雲%舒曉巍%熊正芳%黨小紅
증상휘%왕리운%서효외%웅정방%당소홍
不育,女(雌)性%促甲状腺素%受精,体外%精子注射,细胞质内%治疗结果
不育,女(雌)性%促甲狀腺素%受精,體外%精子註射,細胞質內%治療結果
불육,녀(자)성%촉갑상선소%수정,체외%정자주사,세포질내%치료결과
Infertility,female%Thyrotropin%Fertilization in vitro%Sperm injections,intracytoplasmic%Treatment outcome
目的 探讨青海地区不孕症患者基础促甲状腺素(bTSH)水平对体外受精(IVF)或卵母细胞胞质内单精子注射法(ICSI)治疗结局的影响.方法 前瞻性分析2012年1月1日至2013年12月31日青海省人民医院生殖中心282个IVF周期和93个ICSI周期,根据患者的bTSH水平分为4个区间(≤1.7、＞1.7～≤2.5、＞2.5～≤3.5、＞3.5 mU/L),观察不同bTSH水平不孕症患者行IVF/ICSI治疗后的种植率、生化妊娠率、临床妊娠率、流产率、活产率等结局的差异.结果 (1)在375个IVF/ICSI周期中,bTSH水平与流产率呈正相关(r=0.42,P=0.04),与活产率和种植率呈负相关(r=-0.42、-0.28,P=0.04、0.03),而与获卵数、受精卵数、可移植胚胎数、优质胚胎数、生化妊娠率、临床妊娠率、移植当日子宫内膜厚度均无明显相关性(P＞0.05).(2)bTSH水平≤1.7、＞1.7～≤2.5、＞2.5～≤3.5、＞3.5 mU/L患者的种植率分别为28.7％、27.3％、37.7％、19.2％,活产率分别为80.9％、75.0％、82.7％、59.8％,流产率分别为19.0％、15.0％、16.7％、40.1％,4者的种植率、活产率、流产率分别比较,差异均有统计学意义(P＜0.05),bTSH水平低的患者流产率较bTSH水平高者低,其种植率、活产率相对较高.结论 当bTSH水平＞3.5 mU/L时,不孕症患者的流产率升高,活产率、种植率降低,需关注IVF/ICSI治疗前患者的甲状腺功能变化.
目的 探討青海地區不孕癥患者基礎促甲狀腺素(bTSH)水平對體外受精(IVF)或卵母細胞胞質內單精子註射法(ICSI)治療結跼的影響.方法 前瞻性分析2012年1月1日至2013年12月31日青海省人民醫院生殖中心282箇IVF週期和93箇ICSI週期,根據患者的bTSH水平分為4箇區間(≤1.7、＞1.7～≤2.5、＞2.5～≤3.5、＞3.5 mU/L),觀察不同bTSH水平不孕癥患者行IVF/ICSI治療後的種植率、生化妊娠率、臨床妊娠率、流產率、活產率等結跼的差異.結果 (1)在375箇IVF/ICSI週期中,bTSH水平與流產率呈正相關(r=0.42,P=0.04),與活產率和種植率呈負相關(r=-0.42、-0.28,P=0.04、0.03),而與穫卵數、受精卵數、可移植胚胎數、優質胚胎數、生化妊娠率、臨床妊娠率、移植噹日子宮內膜厚度均無明顯相關性(P＞0.05).(2)bTSH水平≤1.7、＞1.7～≤2.5、＞2.5～≤3.5、＞3.5 mU/L患者的種植率分彆為28.7％、27.3％、37.7％、19.2％,活產率分彆為80.9％、75.0％、82.7％、59.8％,流產率分彆為19.0％、15.0％、16.7％、40.1％,4者的種植率、活產率、流產率分彆比較,差異均有統計學意義(P＜0.05),bTSH水平低的患者流產率較bTSH水平高者低,其種植率、活產率相對較高.結論 噹bTSH水平＞3.5 mU/L時,不孕癥患者的流產率升高,活產率、種植率降低,需關註IVF/ICSI治療前患者的甲狀腺功能變化.
목적 탐토청해지구불잉증환자기출촉갑상선소(bTSH)수평대체외수정(IVF)혹란모세포포질내단정자주사법(ICSI)치료결국적영향.방법 전첨성분석2012년1월1일지2013년12월31일청해성인민의원생식중심282개IVF주기화93개ICSI주기,근거환자적bTSH수평분위4개구간(≤1.7、＞1.7～≤2.5、＞2.5～≤3.5、＞3.5 mU/L),관찰불동bTSH수평불잉증환자행IVF/ICSI치료후적충식솔、생화임신솔、림상임신솔、유산솔、활산솔등결국적차이.결과 (1)재375개IVF/ICSI주기중,bTSH수평여유산솔정정상관(r=0.42,P=0.04),여활산솔화충식솔정부상관(r=-0.42、-0.28,P=0.04、0.03),이여획란수、수정란수、가이식배태수、우질배태수、생화임신솔、림상임신솔、이식당일자궁내막후도균무명현상관성(P＞0.05).(2)bTSH수평≤1.7、＞1.7～≤2.5、＞2.5～≤3.5、＞3.5 mU/L환자적충식솔분별위28.7％、27.3％、37.7％、19.2％,활산솔분별위80.9％、75.0％、82.7％、59.8％,유산솔분별위19.0％、15.0％、16.7％、40.1％,4자적충식솔、활산솔、유산솔분별비교,차이균유통계학의의(P＜0.05),bTSH수평저적환자유산솔교bTSH수평고자저,기충식솔、활산솔상대교고.결론 당bTSH수평＞3.5 mU/L시,불잉증환자적유산솔승고,활산솔、충식솔강저,수관주IVF/ICSI치료전환자적갑상선공능변화.
Objective To study basic thyroid stimulating hormone (bTSH) levels impact on outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in Qinghai.Methods Totally 282 cases with IVF cycles and 93 cases with ICSI cycles were studied prospectively,according to bTSH level,patients were divided into four groups.Reproduction rate,clinical pregnancy rate,miscarriage rate and live birth rate were studied among four groups.Results (1) In 375 cases with IVF/ICSI cycles,bTSH was positively correlated with abortion rate (r=0.42,P=0.04),but live birth rate and growing rate showed negative correlations with bTSH (r=-0.42,-0.28; P=0.04,0.03).bTSH and the number of eggs,the number of fertilized eggs,the number of embryos,biochemical pregnancy rate,and clinical pregnancy rate were no significant correlation (all P＞0.05).(2) Among women at group of ≤1.7,＞1.7 and ≤2.5,＞2.5 and ≤3.5,＞3.5 mU/L,the implantation rates were 28.7％,27.3％,37.7％ and 19.2％,live birth rates were 80.9％,75.0％,82.7％,and 59.8％,abortion rates were 19.0％,15.0％,16.7％,40.1％; they all showed significant difference (all P＜0.05).Abortion rate in women with high bTSH level was higher than that of women with lower bTSH level,however implantation rate,live birth rate in women with high bTSH level were lower.Conclusion When bTSH level is ＞3.5 mU/L,the abortion rate were increased,but live birth rate,rate of implantation were decreased.
