南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (07): 1050-.

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胚胎移植术后9和11 d血清β-HCG值对妊娠结局的预测价值

陈彩蓉,全松,王秋香,李艳红,邱佩嫦,赵晓英,周林荣,郭海燕   

  • 出版日期:2015-07-20 发布日期:2015-07-20

Value of serum beta-human chorionic gonadotropin on day 9 and 11 after embryo
transfer in predicting pregnancy outcomes

  • Online:2015-07-20 Published:2015-07-20

摘要: 目的探讨胚胎移植术后9 d和11 d血清β人绒毛膜促性腺激素(β-HCG)水平对体外受精/胚胎移植(IVF-ET)或冻融复苏
胚胎移植(FET)术后妊娠结局早期诊断的预测价值。方法选择2012年12月~2014年2月清远市人民医院生殖医学中心227个
胚胎移植周期,胚胎移植后9 d和11 d检测血清β-HCG,并追踪妊娠结局,应用ROC曲线确定移植后9 d和11 d具有预测各种妊
娠结局的最佳血清β-HCG界值。结果(1)将患者妊娠结局分为:未孕组(A)、生化妊娠组(B)和临床妊娠组(C);A、B、C3组移植
后9 d和11 d血清β-HCG值组间比较差异显著(P<0.01);(2)C组内分为单胎妊娠组(C1)、双胎妊娠组(C2)、早孕流产组(C3)、
宫外孕组(C4)、宫内合并宫外孕组(C5);C1~C5 五组9 d 和11 d 血清β-HCG值组间比较差异显著(P<0.01);(3)移植后9 d,
预测临床妊娠和双胎妊娠的β-HCG最佳阈值分别为49.05 U/L和105.15 U/L;移植后11 d,预测临床妊娠和双胎妊娠的β-HCG
最佳阈值分别为51.2 U/L和241.75 U/L。结论胚胎移植后9 d及11 d的血清β-HCG定量可准确诊断是否妊娠,并可以预测生
化妊娠、临床妊娠,及单双胎妊娠等不同妊娠结局。

Abstract: Objective To investigate the value of serum beta-human chorionic gonadotropin (β-HCG) on days 9 (d9) and 11
(d11) after fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET) in predicting the pregnancy outcomes.
Methods A total of 227 fresh ET and FET cycles performed at the Center of Reproductive Medicine, Qingyuan People’s
Hospital between Dec, 2012 and Feb, 2014 were analyzed. The data of serum β-HCG levels on d9 and d11 after fresh ET and
FET cycles and the pregnancy outcomes were reviewed, and the ROC curve was constructed to determine the optimal cut-off
level of serum β-HCG level for predicting pregnancy outcomes. Results According to pregnancy outcomes, the cycles were
divided into non-pregnancy group (group A), biochemical pregnancy group (group B), and clinical pregnancy group (group
C). Significant differences were found between the mean serum β-HCG levels measured on d9 and d11 in all the 3 groups (P<
0.01). The cycles in group C were further divided into 5 subgroups with single pregnancy (C1), twin pregnancy (C2), early
abortion (C3), ectopic pregnancy (C4), or intrauterine pregnancy complicated with ectopic pregnancy group (C5), and all the 5
subgroups showed significant differences in β-HCG measurements between d9 and d11 (P<0.01). On d9 after ET and FET, the
optimal cut-off level of serum β-HCG was 49.05 IU/L for predicting for clinical pregnancy, and was 105.15 IU/L for predicting
twin pregnancy; the two corresponding cut-off levels of serum β-HCG on d11 was 51.2 IU/L and 241.75 IU/L, respectively.
Conclusion The absolute serum β-HCG level on d9 and d11 after fresh ET and FET allows an accurate diagnosis of pregnancy
and helps in the prediction of the pregnancy outcomes.