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子宫内膜厚度与新鲜体外受精-胞浆内单精子注射和胚胎移植周期中小胎龄儿的发生率有关。

Endometrial thickness is associated with incidence of small-for-gestational-age infants in fresh in vitro fertilization-intracytoplasmic sperm injection and embryo transfer cycles.

机构信息

School of Medicine, Shandong University, Jinan, People's Republic of China; Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, Jinan, People's Republic of China; National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology at Shandong University, Ministry of Education, Jinan, People's Republic of China.

Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, Jinan, People's Republic of China.

出版信息

Fertil Steril. 2020 Apr;113(4):745-752. doi: 10.1016/j.fertnstert.2019.12.014. Epub 2020 Mar 5.

DOI:10.1016/j.fertnstert.2019.12.014
PMID:32147172
Abstract

OBJECTIVE

To investigate whether endometrial thickness (EMT) is associated with adverse obstetric and neonatal outcomes in fresh in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles.

DESIGN

Retrospective cohort study.

SETTING

University-based reproductive medical center.

PATIENT(S): Women under the age of 42 years who underwent IVF/ICSI treatment and received fresh ET in our unit from January 2017 to December 2018, resulting in a live singleton birth.

INTERVENTION(S): Controlled ovarian hyperstimulation and IVF/ICSI; fresh ET.

MAIN OUTCOME MEASURE(S): Birth weight, gestational age, small for gestational age (SGA), large for gestational age (LGA), placenta previa, placental abruption, hypertensive disorders, and gestational diabetes mellitus.

RESULT(S): The risk of being born SGA was statistically significantly increased in the EMT ≤7.5 mm group compared with those from the EMT >12 mm group (adjusted odds ratio [aOR] 2.391; 95% confidence interval [CI], 1.155-4.950). Moreover, maternal body mass index, secondary infertility, preterm delivery, and hypertensive disorders were all independent predictors for SGA. The mean birth weights of singletons in women with EMT ≤7.5 mm were lower than in the groups with EMT >7.5-12 mm and EMT >12 mm (3.25 ± 0.56 kg vs. 3.38 ± 0.51 kg and 3.39 ± 0.53 kg, respectively).

CONCLUSION(S): After fresh IVF/ICSI-ET, the risk of SGA was increased twofold in women with EMT ≤7.5 mm compared with women with EMT >12 mm. We suggest that women with a thin EMT after obtaining a pregnancy by IVF should receive improved prenatal care to reduce the risk of delivering a SGA infant.

摘要

目的

研究子宫内膜厚度(EMT)是否与新鲜体外受精/胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)周期中的不良产科和新生儿结局有关。

设计

回顾性队列研究。

地点

大学附属生殖医学中心。

患者

2017 年 1 月至 2018 年 12 月在我院接受 IVF/ICSI 治疗并接受新鲜 ET 的年龄<42 岁的女性,最终分娩活单胎。

干预措施

控制性卵巢超刺激和 IVF/ICSI;新鲜 ET。

主要观察指标

出生体重、胎龄、小于胎龄儿(SGA)、大于胎龄儿(LGA)、前置胎盘、胎盘早剥、高血压疾病和妊娠期糖尿病。

结果

与 EMT>12mm 组相比,EMT≤7.5mm 组的 SGA 出生风险显著增加(调整优势比[aOR]2.391;95%置信区间[CI]1.155-4.950)。此外,母体体重指数、继发不孕、早产和高血压疾病都是 SGA 的独立预测因素。EMT≤7.5mm 的女性所分娩的单胎新生儿的平均出生体重低于 EMT>7.5-12mm 和 EMT>12mm 的女性(3.25±0.56kg 比 3.38±0.51kg 和 3.39±0.53kg)。

结论

与 EMT>12mm 的女性相比,新鲜 IVF/ICSI-ET 后 EMT≤7.5mm 的女性 SGA 风险增加两倍。我们建议,通过 IVF 怀孕后 EMT 较薄的女性应接受更好的产前保健,以降低 SGA 婴儿的分娩风险。

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