异位妊娠与着床窗移位风险增加相关：一项回顾性研究。

Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study.

作者信息

Zeng Hong, Chang Yahan, Liu Nenghui, Li Shuyi

机构信息

Department of Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.

Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha, 410008, Hunan, China.

出版信息

BMC Pregnancy Childbirth. 2024 Dec 20;24(1):839. doi: 10.1186/s12884-024-07072-z.

DOI:10.1186/s12884-024-07072-z

PMID:39707276

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11661333/

Abstract

BACKGROUND

To evaluate the risk factors associated with WOI (window of implantation) displacement based on ERT (endometrial receptivity test), and to confirm the association of ectopic pregnancy with WOI displacement.

METHODS

This is a retrospective study at the Reproductive Medicine Center of Xiangya Hospital from January 2020 to April 2024, consisting of 934 patients who performed ERT. The patients underwent 3771 assisted reproductive technology (ART) cycles and 2629 embryo transfer (ET) cycles, with each patient experiencing at least one implantation failure. The study utilized generalized estimation equation (GEE) models to examine factors associated with WOI displacement, adjusting for confounding factors like age, body mass index (BMI), and infertility type. Non-linear relationships between age or BMI with WOI displacement were explored using generalized additive models (GAM) with thresholds detected by segmented regression.

RESULTS

Among the patients, 60.17% were in the receptive phase, 39.40% in the pre-receptive phase, and 0.43% in the post-receptive phase. Ectopic pregnancy history increased the risk of WOI displacement by 62% (aOR 1.62, 95%CI 1.03-2.53, P = 0.035), patients over 35 years old had a 50% higher risk of WOI displacement compared to patients under 34 (aOR 1.50, 95% CI 1.12-2.00, P = 0.007). Secondary infertility showed a 26% lower risk of WOI displacement than primary infertility without statistical significance (aOR 0.74 95% CI 0.54-1.02, P = 0.062). BMI ≥ 22 kg/m2 was associated with a 25% increased risk of WOI displacement without statistical significance (aOR 1.25, 95% CI 0.94-1.67, P = 0.12).

CONCLUSION

Ectopic pregnancy and advanced age (≥ 35) are significantly associated with increased risk of WOI displacement. Primary infertility and higher BMI (≥ 22 kg/m) tend to increase the risk of WOI displacement though without statistical significance.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

基于子宫内膜容受性测试（ERT）评估与着床窗（WOI）移位相关的危险因素，并确认异位妊娠与WOI移位之间的关联。

方法

这是一项于2020年1月至2024年4月在湘雅医院生殖医学中心进行的回顾性研究，纳入了934例行ERT的患者。这些患者共进行了3771个辅助生殖技术（ART）周期和2629个胚胎移植（ET）周期，每位患者至少经历一次着床失败。本研究采用广义估计方程（GEE）模型来检验与WOI移位相关的因素，并对年龄、体重指数（BMI）和不孕类型等混杂因素进行了调整。使用广义相加模型（GAM）和分段回归检测的阈值来探索年龄或BMI与WOI移位之间的非线性关系。

结果

在这些患者中，60.17%处于容受期，39.40%处于容受前期，0.43%处于容受后期。异位妊娠史使WOI移位风险增加62%（校正优势比[aOR]1.62，95%置信区间[CI]1.03 - 2.53，P = 0.035），35岁及以上患者的WOI移位风险比34岁以下患者高50%（aOR 1.50，95% CI 1.12 - 2.00，P = 0.007）。继发性不孕患者的WOI移位风险比原发性不孕患者低26%，但无统计学意义（aOR 0.74，95% CI 0.54 - 1.02，P = 0.062）。BMI≥22 kg/m²与WOI移位风险增加25%相关，但无统计学意义（aOR 1.25，95% CI 0.94 - 1.67，P = 0.12）。