IVF ICSI助孕新鲜胚胎移植周期早期妊娠丢失的多因素分析.pdf

该【IVF ICSI助孕新鲜胚胎移植周期早期妊娠丢失的多因素分析 】是由【学习好资料】上传分享，文档一共【6】页，该文档可以免费在线阅读，需要了解更多关于【IVF ICSI助孕新鲜胚胎移植周期早期妊娠丢失的多因素分析 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。:..·344·??????2023?3??32??3?DOI:.1004‐??????????????????????12324*??,???,???,???,???(1.????????.3;523808??,????????????.2;518172??,????????????????????????,??519000;4.??????????????,??519000)【??】????????/?????????(IVF/ICSI)???????????????????????。??????12?2020??9?2017???????????????????IVF/ICSI???????????1009???????,?????????????(?=165)??????(???,?=844)。б??????????、????????、??????????,????citsigoL???????????????????,????????????????。???????б,???????????、??????、??????(PR)б???、Gn?????、???DNA???????、????、????????;)<?(?????????,???????(BMI)、HCG?????、??????(??、Gn???、HCG?)?????、?????、???????????????????(?>)。?????????:????[??=,95%??(,),?=]?????[??=,95%??(,),?=]?IVF/ICSI????????????????????????,?????≤35?????????>35?????????,????≤3?????????????>3?????????。??????????????IVF/ICSI?????????????????????,????????????3?????????????,????????????????????????。【???】????;?????????;??????;????????;???【?????】【?????】A??????????????????????????????????????????????????/?????????12324*?????????,??????‐???,?????‐???,????????‐????,??????‐????1.?????????????????????????????????????,??????????????????????????????????????????????????????????????,????????5181722.????????????????????,??????????????????????????,????????5238083.??????????????????????????????????,???????????????????????????????????????,??????5190004.??????????????????????????,???????????????????????????????????????,??????519000【????????】?????????:heinfluencefactorsassociatedwithearlypregnancylossinfreshIVF/ICSIcycle.???????:Theclinicaldataof1009freshIVF/(EPL)group(?=165)andlivebirth(LB)group(?=844)【????】2022‐08‐10;【????】2022‐10‐23【????】???????????(2019A1515010875)【????】??,?,?????,??,?????,??????.(*????,Email:summerxjy2008@):..??????2023?3??32??3?·345·,hormonelevelsindifferentperiods,.???????:ComparedwithLBgroup,thewomenintheEPLgroupwereolder,hadlongerinfertilityyears,lowerproportionofspermforwardmovement(PR),andhighertotalamountofGn,andthedifferencesweresignificant(?<).However,therewerenosignificantdifferencesinfertilizationmode,infertilitytype,maleageandspermDNAfragmentationrate,femalebodymassindex(BMI),endometrialthicknessonHCGday,femalehormonelevelsindifferentperiods(basic,Gninitialday,HCGday),normalfertilizationrateandthenumbersofavailableandhigh‐qualityembryosbetweenthesetwogroups(?>).Multivariateregressionanalysisshowedthatthefemaleage[??=,95%??(,),?=]andinfertilityduration[??=,95%??(,),?=]weretheindependentinfluencingfactorsinfreshIVF/,thelivebirthrateinwomenaged≤>,thelivebirthrateinwomenwithinfertilitydurations≤>3years.???????????:ThefemaleageandinfertilitydurationarethemainfactorsthataffecttheearlypregnancylossintheassistedfreshembryotransfercycleofIVF/,es.????????:IVF;ICSI;Freshembryotransfer;Earlypregnancyloss;Multivariateanalysis(??????????2023,32(03):344‐349)?????????????,??80%?????????????IVF/ICSI‐ET????[1]?????????。??????????????????。????%,??????????????????:(1)?????σ???????????(<20??>35?)、????>40?、????;(2)?????????;(3)????????????????(BMI)、?????、??、????12??????;(4)????????????????[2]。??????/????????;(5)???????????。???—????(IVF/ICSI‐ET)??????????:(1)?????σ???????;?,??????50%??,?????????(2)???????????????;(3)???[3]???????)4(;????????ICSI/IVF。%~%??。???????0091?????)ART(??????????IVF/ICSI????????。?????????,???????、??????????????????(?=165)??????(PCOS)?????????[4]。?Б?,???(???,?=844)。?????????б,??????IVF/ICSI????、?????????????[4]。Ч???????‐ET????:????σ???????????????????,?????????σ。????FSH(rFSH,?????,??????????????ART???????)?/????FSH(uFSH,????)????????。?????,??????B????。????1???????≥18mm???2????????????≥17mm?,??????????(HCG,η?、?????,?????,??)250μg,36~38h???????2017?9??2020?12?????????????。??????????(37℃、:..·346·??????2023?3??32??3?6%CO2)???3~6h??IVF/ICSI,???????????、?????????。???72h??1~2?????,????????????、?????????HCG(????)????(????)?????。???1009?IVF/ICSI????????,2.????:?????ICSI/IVF‐ET?????????????????????。??????????????4???:(1)???????б,????????????、??????????:????、????、????????;)<?(????????,?、??、??????、????、???????????)2(;????、BMI?BMI、?????????????:???????(FSH)、???????(?>)(?1)。(LH)、?????????、?????、)T(????、)2E(??????????????(PRL)、???FSH?LH、HCG?E2?P、б?HCG???????、Gn???、Gn???;??????????б?,??FSH、LH、(3)??????:??????(PR)、DNA??E2、T、PRL,???FSH、LH、E2,HCG?LH、E2、?。(4)????:?????、????????P、??????,Gn??????????(?>????。);??????Gn??????????(?<?、?????)(?2)。???????????、?????。?????????б?????????б[?(%)]???????,???????,?????б,????????2??????????;??????????????(PR)б?????(?<);???χ???,????????????(?????)???DNA???????????(?<)[?(?25,?75)]???????,???‐????(?3)。???????????。???????????、?????????б??(?<)???????logistics????,??????????б?,?????、?????????????????。?<???????????????????(?>)????????。(?4)。???????????б?[?(%)]????????*?????????≤30?30~≤35?>35?≤30?30~≤35?>35?IVFICSI???844298()385()161()180()340()324()729()115()MDB$244??镲'?????16543()64()58()28()64()73()140()25()MDB$244??镲'??/?#晻?<#晻??BMI/(kg/m2)????????*?????≤~≤>????????≤3?>3?W缮鲻b唵憫???84488()551()205()383()461()484()360()厖DH=鼢od趑悙祆贩?????16510()113()42()68()97()76()89()厖DH=鼢od趑悙祆贩??/?.?.?:????б?,*?<。:..??????2023?3??32??3?·347·????????????????????б?[?(?25,?75)]??????????????????FSH/LH/E2/PRL/FSH/LH/E2/(U/L)(U/L)(pmol/L)(nmol/L)(U/L)(U/L)(pmol/L)???(,)(,)(,)(,)(,)(,)(,)m排V煙U刎行排CZ$档^a汉屯`!膊ii?????(,)(,)(,)(,)(,)(,)(,)m排V煙U刎行排CZ$档^a汉屯`!膊ii??/?-------+}6滗摀悙垐垐洓!,?+}6滗摀悙垐垐洓!,HCG????????LH/(U/L)E2/(pmol/L)P/(nmol/L)???(,)(,)(,)技K佑乔揶4"创舷tΖ'?????(,)(,)(,)技K佑乔揶4"创舷tΖ'??/?---??????HCG???????(mm)Gn???Gn???(U)???84411(10,13)11(10,12)2700(2065,3300)'?????16511(10,12)11(10,12)3000(2250,3600)*'??/?---#鲻-槝?#鲻-槝?:????б?,*?<。?????????????б?[?(?25,?75)]?????????????(PR)、Gn???、??????PR??б?DNA??????、????,??????????(?5),?。????Logistic??????)27,15(21),(????????湝妸い弿*?,????>35?[??=,95%??(,?????(,)22(15,28)),?=]?????>3?[??=,??/?--%??(,),?=]???IVF/ICSI厖技北z??????????????????????厖技北z?:????б?,*?<。(?<),?????≤35?????????>35?????????,????≤3????????????б?[?(?25,?75)]????????????>3??????????????(?6)。???????????????????????????????????(,)4(2,6)2(1,4)D?????????(,)4(2,6)2(1,3)D???????1≤50=1>50=2E8??/?<1邋膊????2≤30?=130~≤35=2>35?=3浇谮<1觋邋觋邋膊*?????3≤3?=1>3?=2~媼?、??IVF‐ET/ICSI?????????????????=0??=1;?????????,??IVF‐ET/ICSI??:..·348·??????2023?3??32??3?????IVF‐ET/ICSI?????Logistic???????э???.?.?????????95%??E膊??????(,)厖墘侣Z<北~1ge悙Gn???-(,)厖墘侣Z<北~1ge悙????????(≤35?)-(,)厖墘侣Z<北~1ge悙????(>35?)-(,)厖墘侣Z<北~1ge悙????(>3?)-(,)厖墘侣Z<北~1ge悙??<<1ge悙??????????????????,???????????。?????????,?????ART???????????????????????????,???2????????、??、?????????12~9???6??,%30??、??????、BMI??、?????[5]????、????????ART???。??????8%?4%,??,????????????????????ART??????????????????????????????????[6]。Ч???????,???????????[15]。??????,?????????[16]??IVF/ICSI?????????????,?????,????????????,??≤35??????????>35????,?????????。??,??????>3??????????。??????????、????????ART??,??????А??。[7]??、?????????????。????Ч???????????????????Б?,????????ART????????IVF/ICSI????Gn???????????????????????????Gn???ART。????????????????,]9‐8]?[10][17]?。????????????????????,??????????????731??????????????,??П???????????????,Gn??????IVF/ICSI????????????????????????????????。??????????[11]?,?????????????????????????,??????С???????????????????。Ч??????[18]?;???????(PCOS)????LH???,?????????????????、???????????????[19]。??,??????????????????????。??,?????LH???LH/FSH?????????????,???40????IVF/ICSI?????????[20]。Ч?????????????,?б?????,????????????????IVF/ICSI?????????,????????[12]。???ART????????,??????????????????、????????????????ART??,????????????б??。?????。???????IVF/ICSI?????????????IVF/ICSI??????????????。????????DNA????????。?????,IVF/ICSI?????????????????????。????,?????????????[12],?????????????DNA?????IVF‐ET/ICSI????[13]。Ч????????????????≤3???????,???????????DNA??????????????>3?????????,???、????????????П。?Б?,?????IVF/ICSI????????????[21‐22]。?Ч???????????????????,]14]?????????????,????????DNA????IVF‐ET/:..??????2023?3??32??3?·349·ICSI?????????????????,??IVFandICSI[J].,2009,26:93‐97.???ART???????????????[11]????????,SandalinasM,Bah?eM,‐stagehumanembryos[J/OL].?,????????????????????ReprodBiomedOnline,2000,1:17‐26.???,??????????????????[12]CaiQF,WanF,HuangR,??????????????[23]。eofIVF/ICSItreatment:amultivariable????,??????????IVF/ICSIanalysisof2450patients[J].HumReprod,2011,26:??????????????????????2532‐2540.[13]LintsenAM,EijkemansMJ,,??,?????????3?????????ongoingpregnancychancesafterIVFandICSI:anational??ART????,????????????prospectivestudy[J].HumReprod,2007,22:2455‐2462.?,?????????。[14]WangAC,WangY,WuFX,【????】womeninIVF/ICSI‐infreshcycles[J].BiomedRep,2017,7:482‐486.[1]VitezSF,FormanEJ,[15]BuckettW,[J].SeminPerinatol,2019,infertility:anevidence‐basedguidelinefromtheCanadian43:116‐[J/OL].ReprodBiomed[2]QuenbyS,GallosID,Dhillon‐SmithRK,,2019,39:633‐:theepidemiological,physical,psychological,and[16]YilmazT,YaziciS,[J].Lancet,2021,397:distressofinfertilewomen:across‐sectionalstudy[J].J1658‐,2020,41:275‐281.[3]CaiH,MolBW,GordtsS,[17]FriedlerS,MeltzerS,Saar‐RyssB,:aretrospectivecohortanalysisof21820advocated[J].GynecolEndocrinol,2016,32:965‐[J].BJOG,2021,128:1160‐1169.[18]ZhuangJ,LiH,LiX,[4]YangAM,XuX,HanY,[J].Medicinetypesofpregnancylosses:analysisof15,210pregnancies(Baltimore),2019,98:[J].FrontEndocrinol(Lausanne),[19]WangN,ZhuQ,MaM,parisonofaprogestin‐2021,12:[5]AgenorA,:antagonistprotocolinpatientswithpolycysticovarycommonpathwaysinmanifestationandmanagement[J].syndromewhoareparticipatinginanIVFprogramme:stud