拮抗剂方案IVF患者hCG注射日雌/孕激素比值对妊娠结局的预测价值

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目的:探讨卵巢储备能力正常的不孕症患者在拮抗剂方案超促排卵周期中人绒毛膜促性腺激素(h CG)注射日血清孕酮/雌二醇(P/E2)比值对体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)妊娠结局的预测价值。方法:回顾性分析103例接受拮抗剂方案超促排卵且卵巢储备能力正常患者的临床资料,采用受试者工作特征曲线(receiver operating characteristic,ROC)筛选h CG注射日P/E2比值对妊娠结局预测的最佳阈值并根据该阈值进行分组,比较组间的临床参数,采用Logistic回归分析研究h CG注射日P/E2比值和临床妊娠之间的关系。结果:拮抗剂方案中h CG注射日P/E2比值最佳阈值为0.26,P/E2比值≤0.26组临床妊娠率明显高于P/E2比值>0.26组(57.69%vs 21.56%,P<0.001)。Logistic回归分析结果显示P/E2比值可以作为一个独立的临床妊娠结局的预测指标,该指标具有64.5%的敏感度和74.2%的特异度。结论:对卵巢储备能力正常且采用拮抗剂方案治疗的患者,虽然h CG注射日P/E2比值≤0.26者临床妊娠率明显增高,该比值对IVF妊娠结局具有一定的预测价值。 OBJECTIVE: To investigate the effect of serum progesterone / estradiol (P / E2) ratio on human chorionic gonadotropin (hCG) injection on the duration of the antagonistic agent superovulation cycle in infertility patients with normal ovarian reserve, Predictive value of pregnancy outcome in in vitro fertilization and embryo transfer (IVF-ET). Methods: The clinical data of 103 patients with ovarian hyperstimulation and normal ovarian reserve were retrospectively analyzed. The receiver operating characteristic (ROC) screen was used to screen the ratio of P / E2 on h CG injection day to the pregnancy outcome The optimal thresholds were predicted and grouped according to the thresholds. The clinical parameters were compared between groups. Logistic regression analysis was used to investigate the relationship between P / E2 ratio and clinical pregnancy at h CG injection. Results: The optimal threshold of P / E2 ratio on h CG injection day was 0.26 and the clinical pregnancy rate of P / E2 ratio ≤0.26 group was significantly higher than that of P / E2 ratio> 0.26 group (57.69% vs 21.56%, P <0.001) ). Logistic regression analysis showed that the P / E2 ratio could serve as a predictor of independent clinical pregnancy outcomes with a sensitivity of 64.5% and a specificity of 74.2%. CONCLUSIONS: For patients with normal ovarian reserve and treated with the antagonist regimen, although the clinical pregnancy rate was significantly higher at h CG injection day with a P / E2 ratio of ≤0.26, this ratio has some predictive value for IVF pregnancy outcome.
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