目的 探讨体外受精-胚胎移植(IVF-ET)助孕妊娠后发生早期自然流产的相关因素。方法 对2010年1月1日-2012年12月31日在新疆医科大学第一附属医院生殖中心行IVF/ICSI新鲜胚胎移植后的598例妊娠病例进行分析,排除异位妊娠、晚期流产及资料不齐全者21例后,577例病例分为早期流产组(59例)和活胎分娩组(518例),运用单因素和多因素logistic方法 比较两组的相关指标。结果 早期自然流产发生率为10.20%,早期流产组和活胎分娩组在年龄[(33.25±4.95)岁和(30.41±3.18)岁]、不孕年限[(5.87±4.16)a和(5.16±3.28)a]、基础黄体生成素水平[(8.94±2.30)mIU/mL和(5.47±1.60)mIU/mL]和HCG注射日雌二醇水平[(2350.15±476.51)pg/mL和(1885.45±176.15)pg/mL]方面比较,差异均有统计学意义(P〈0.05)。多因素Logistic回归分析结果 显示,年龄是早期自然流产的危险因素(OR=1.47,95%CI:1.01~2.13)。结论 患者高龄、不孕年限长、基础黄体生成素水平高、HCG注射日雌二醇水平过高者,IVF-ET助孕妊娠后发生早期流产的风险增加。
Objective To investigate the relative risk factors for early abortion among pregnancies after in vitro fertilization and embryo transfer techniques. Methods Following in vitro fertilization(IVF)/intracytoplasmic sperm injection (ICSI) treatment , a retrospective analysis was performed on 598 patients with pregnancy including 61 early abortion cases and 516 pregnancies with live birth after exclusion of 21 cases with incomplete data or late abortion,and the risk factors of early abortion were investigated. Results Significant difference was found in the maternal age [(33.25±4.95) yrs vs (30.41±3.18) yrs],the duration of infertility [(5.87±4.16) yrs vs (5.16±3.28) yrs], basal luteinzing hormone (LH) level [(8.94±2.30) mIU/mL vs (5.47±1.60) mIU/mL], serum estradiol level on the day of hCG administration [(2 350.15±476.51) pg/mL vs (1 885.45±176.15) pg/mL]. Multivariate Logistic regression analysis indicated that old age could be a risk factor for early spontaneous abortion (OR =1.47, 95% CI :1.01-2.13) . Conclusion Women at elder age,or with long duration of infertility, high basal LH leveland high serum estradiol level on the day of hCG administration could have a higher risk of spontaneous early abortion in pregnancies after IVF-ET.