McCoy Travis W, Nakajima Steven T, Bohler Henry Cl
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Women's Health, University of Louisville, 601 South Floyd Street, Suite 300, Louisville, KY 40202, USA.
Reprod Biomed Online. 2009 Jul;19(1):114-20. doi: 10.1016/s1472-6483(10)60054-5.
The current study was undertaken to investigate the use of beta human chorionic gonadotrophin (beta-HCG) concentration and other significant factors to predict the likelihood of an IVF pregnancy progressing to detection of cardiac activity by ultrasound, and to create data tables which can be used for patient counselling. A retrospective data analysis was undertaken of 1374 IVF cycles performed from January 1997 to July 2007, resulting in 662 pregnancies. Maternal age (P = 0.0005), day-14 (P < 0.001) and day-16 (P < 0.001) post-oocyte aspiration beta-HCG concentrations were found to be significant in predicting pregnancy outcome. Multiple logistic regression modelling revealed that the most accurate predictive model used a single day-14 beta-HCG concentration and maternal age. Day-14 and day-16 beta-HCG concentrations were highly correlated, with the addition of a day-16 concentration adding no additional predictive value. Ongoing pregnancy rates were proportional to day-14 beta-HCG concentration and inversely proportional to maternal age. The multiple pregnancy incidence increased proportionally with the initial beta-HCG concentration. Thus, for the counselling of patients following IVF, a single day-14 post-oocyte-aspiration beta-HCG concentration and maternal age are most predictive of the pregnancy continuing to detection of cardiac activity by ultrasound.
本研究旨在探讨β-人绒毛膜促性腺激素(β-HCG)浓度及其他重要因素对预测体外受精(IVF)妊娠进展至超声检测到心脏活动可能性的作用,并创建可用于患者咨询的数据表。对1997年1月至2007年7月期间进行的1374个IVF周期进行回顾性数据分析,共产生662例妊娠。发现母体年龄(P = 0.0005)、卵母细胞抽吸后第14天(P < 0.001)和第16天(P < 0.001)的β-HCG浓度对预测妊娠结局具有显著意义。多元逻辑回归模型显示,最准确的预测模型使用单个第14天的β-HCG浓度和母体年龄。第14天和第16天的β-HCG浓度高度相关,增加第16天的浓度并无额外的预测价值。持续妊娠率与第14天的β-HCG浓度成正比,与母体年龄成反比。多胎妊娠发生率与初始β-HCG浓度成正比增加。因此,对于IVF术后患者的咨询,单个卵母细胞抽吸后第14天的β-HCG浓度和母体年龄最能预测妊娠是否会持续至超声检测到心脏活动。