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冻融胚胎移植后7天血清β-人绒毛膜促性腺激素水平与妊娠结局的关联:一项来自中国的单中心回顾性研究

Association between 7-day serum β-hCG levels after frozen-thawed embryo transfer and pregnancy outcomes: a single-centre retrospective study from China.

作者信息

Yuan Lihua, Yu Lingyu, Sun Zhengao, Song Jingyan, Xiao Jimei, Jiang Huaying, Sa Yuanhong

机构信息

College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.

Integrative Medicine Research Centre of Reproduction and Heredity, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China

出版信息

BMJ Open. 2020 Oct 10;10(10):e035332. doi: 10.1136/bmjopen-2019-035332.

Abstract

OBJECTIVE

Early monitoring of plasma human chorionic gonadotropin (β-hCG) level is vital in predicting pregnancy outcome. This study investigated the predictive value of serum β-hCG level on the seventh day after frozen-thawed embryo transfer (FET) for ongoing pregnancy (OP) and adverse pregnancy (AP).

DESIGN

Retrospective study.

SETTING

The Reproductive and Genetic Center of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China.

PARTICIPANTS

1061 pregnant women who underwent FET between January 2014 and January 2017.

PRIMARY AND SECONDARY OUTCOME MEASURES

Pregnancy outcome.

RESULTS

Serum β-hCG levels on the seventh day after FET were higher in the single OP group compared with the biochemical pregnancy group (p<0.001). Besides, the serum β-hCG cut-off level at 4.34 mIU/mL on the seventh day showed high predictive value (area under the curve (AUC)=0.852). Serum β-hCG levels on the seventh day after FET were higher in the twin OP group compared with the single OP group (p<0.001). Also, the serum β-hCG cut-off level at 17.95 mIU/mL on the seventh day showed high predictive value (AUC=0.903). Serum β-hCG levels on the seventh day after FET were lower in the ectopic pregnancy group compared with the single OP group (p<0.001) whereas, serum β-hCG cut-off level at 4.53 mIU/mL on the seventh day exhibited a high predictive value (AUC=0.860). Further, the serum β-hCG levels on the seventh day after FET were lower in the single early spontaneous abortion group compared with the single OP group (p<0.001) while the serum β-hCG cut-off level at 5.34 mIU/mL on the seventh day exhibited high predictive value (AUC=0.738).

CONCLUSION

Serum β-hCG on the seventh day after FET has good clinical significance for the prediction of OP and AP.

摘要

目的

早期监测血浆人绒毛膜促性腺激素(β-hCG)水平对预测妊娠结局至关重要。本研究探讨冻融胚胎移植(FET)后第7天血清β-hCG水平对持续妊娠(OP)和不良妊娠(AP)的预测价值。

设计

回顾性研究。

地点

中国山东中医药大学附属医院生殖与遗传中心。

参与者

2014年1月至2017年1月期间接受FET的1061名孕妇。

主要和次要观察指标

妊娠结局。

结果

与生化妊娠组相比,单胎OP组FET后第7天的血清β-hCG水平更高(p<0.001)。此外,第7天血清β-hCG截断水平为4.34 mIU/mL时显示出较高的预测价值(曲线下面积(AUC)=0.852)。与单胎OP组相比,双胎OP组FET后第7天的血清β-hCG水平更高(p<0.001)。同样,第7天血清β-hCG截断水平为17.95 mIU/mL时显示出较高的预测价值(AUC=0.903)。与单胎OP组相比,异位妊娠组FET后第7天的血清β-hCG水平更低(p<0.001),而第7天血清β-hCG截断水平为4.53 mIU/mL时具有较高的预测价值(AUC=0.860)。此外,与单胎OP组相比,单胎早期自然流产组FET后第7天的血清β-hCG水平更低(p<0.001),而第7天血清β-hCG截断水平为5.34 mIU/mL时具有较高的预测价值(AUC=0.738)。

结论

FET后第7天的血清β-hCG对OP和AP的预测具有良好的临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87a9/7549452/c3de45124a8b/bmjopen-2019-035332f01.jpg

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