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激素诱导周期中冻融胚胎移植日血浆孕酮水平对妊娠结局的影响

Impact of Plasmatic Progesterone on the Day of Frozen Embryo Transfer in Hormone-induced Cycles.

机构信息

Hospital Garcia de Orta, Almada, Portugal.

Instituto Valenciano de Infertilidad, Lisboa, Portugal.

出版信息

Rev Bras Ginecol Obstet. 2021 Aug;43(8):608-615. doi: 10.1055/s-0041-1735229. Epub 2021 Sep 21.

Abstract

OBJECTIVE

To establish a relationship between serum progesterone values on the day of frozen blastocyst transfer in hormone-replaced cycles with the probability of pregnancy, miscarriage or delivery.

METHODS

This was an ambispective observational study including all frozen-thawed embryo transfer cycles performed at our department following in vitro fecundation from May 2018 to June 2019. The outcomes evaluated were β human chorionic gonadotropin (β-hCG)-positive pregnancy and delivery. Groups were compared according to the level of serum progesterone on the day of embryo transfer: the 1 quartile of progesterone was compared against the other quartiles and then the 2 and 3 quartiles against the 4 quartile.

RESULTS

A total of 140 transfers were included in the analysis: 87 with β-HCG > 10 IU/L (62%), of which 50 (36%) delivered and 37 had a miscarriage (42%). Women with lower progesterone levels (< 10.7ng/mL) had a trend toward higher β-HCG-positive (72 versus 59%;  > 0.05), lower delivery (26 versus 39%;  > 0.05) and higher miscarriage rates (64 versus 33%;  < 0.01). Comparing the middle quartiles (P25-50) with those above percentiles 75, the rate of pregnancy was similar (60 versus 57%;  > 0.05), although there was a trend toward a higher number of deliveries (43 versus 31%;  > 0.05) and a lower number of miscarriages (28 versus 45%;  > 0.05). These differences were not statistically significant.

CONCLUSION

There were no differences in pregnancy and delivery rates related with the progesterone level when measured in the transfer day. The miscarriage rate was higher in the 1 quartile group.

摘要

目的

建立激素替代周期中冷冻囊胚移植日血清孕酮值与妊娠、流产或分娩概率之间的关系。

方法

这是一项前瞻性观察性研究,纳入了 2018 年 5 月至 2019 年 6 月期间在我科进行的所有体外受精冷冻-解冻胚胎移植周期。评估的结局是β人绒毛膜促性腺激素(β-hCG)阳性妊娠和分娩。根据胚胎移植日血清孕酮水平将患者分为 4 组:第 1 四分位数与其他 3 个四分位数比较,然后第 2 四分位数和第 3 四分位数与第 4 四分位数比较。

结果

共纳入 140 例移植周期进行分析:其中 87 例β-HCG>10IU/L(62%),其中 50 例(36%)分娩,37 例流产(42%)。孕酮水平较低(<10.7ng/ml)的患者β-HCG 阳性率(72%比 59%;>0.05)、分娩率(26%比 39%;>0.05)和流产率(64%比 33%;<0.01)较高。与较高四分位数组(第 75 百分位)相比,中间四分位数组(第 25-50 百分位)的妊娠率相似(60%比 57%;>0.05),但分娩率有升高趋势(43%比 31%;>0.05),流产率较低(28%比 45%;>0.05)。但这些差异无统计学意义。

结论

在移植日测量孕酮水平与妊娠和分娩率无相关性。第 1 四分位数组的流产率较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60c8/10183892/a20b02d6fb0c/10-1055-s-0041-1735229-i200229-1.jpg

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