冻融胚胎移植术后第9 和11 天β-HCG 水平对 单胎妊娠临床结局的预测价值

Predictive value of serum chorionic gonadotropin levels on the 9th and 11th day after freeze-thaw embryo transfer for single

摘要:

目的 探讨冻融胚胎移植术后第9 和11 天血清β- 人绒毛膜促性腺激素（β-HCG）水平对单 胎妊娠临床结局的预测价值。方法 回顾性分析2012 年12 月—2018 年8 月于广州医科大学附属第六医院生 殖中心行冻融胚胎移植术并获得单胎妊娠的342 例患者的临床资料，按不同的妊娠结局将患者分为异位妊娠 组、早期流产组和活产组，比较各组移植后第9 和11 天血清β-HCG 的差异，绘制ROC 曲线计算不同妊娠 结局的β-HCG 界值。结果 各组移植后第9 和11 天β-HCG 比较，差异有统计学意义（P <0.05），在冻 融胚胎移植周期中，移植后第9 天预测单胎宫内妊娠/ 异位妊娠和单胎活产/ 非活产的β-HCG 最佳阈值分 别为27.5 和32.5 IU/L ；移植后第11 天预测单胎宫内妊娠/ 异位妊娠和单胎活产/ 非活产的β-HCG 最佳 阈值分别为77.5 和119.0 IU/L。结论 冻融胚胎移植术后第9 和11 天测定血清β-HCG 水平能有效预测单 胎异位妊娠、单胎早期流产及单胎活产等不同体外受精妊娠结局。

Abstract:

Objective To investigate serum beta-human chorionic gonadotropin (β-HCG) level on day 9 and day 11 as predictors for pregnancy outcome after frozen-thawed embryo transfer (FET) for single pregnancy during in vitro fertilization. Methods A retrospective study was performed in total 342 frozen-thawed embryo transfer cycles at the Center of Reproductive Medicine, the Sixth Affiliated Hospital of Guangzhou Medical Uniwersity between December 2012 and August 2018. The data of serum β-HCG levels on day 9 and day 11 after FET cycles and the pregnancy outcomes were compared among ectopic pregnancy group (A), early abortion group (B) and live birth group (C), and the ROC curve was constructed to determine the optimal cut-off level of serum β-HCG level for predicting pregnancy outcomes. Results Significant differences were found between the mean serum β-HCG levels measured on day 9 and day 11 in all the 3 groups (P < 0.05). The patients' β-HCG threshold value on day 9 that calculated by receiver operator characteristic curves were 27.50 IU/L for uterine and 32.50 IU/L for live birth. The threshold values on day 11 were 77.50 IU/L for uterine pregnancy and 119.00 IU/L for live birth. Conclusion The serum β-HCG level on day 9 and day 11 after FET allows an accurate diagnosis of pregnancy and is helpful in the prediction of the pregnancy outcomes.