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的oai: heighpubs.org: 10.29328 / journal.cjog.1001028
2019-09-11
CJOG:影响
孕酮水平对hCG注射日预测体外受精/ICSI cyclesâ结果的有效性
Mostafa一Abolfotouh
Hallah Al-Anazi
萨玛哈桑
& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>以往的研究强调了体外受精周期中早孕激素升高(PE)对周期结果的负面影响。本研究的目的是评估hCG日(P4)孕酮水平对体外受精/ICSI周期预测的有效性。结果。;/ p>& lt; p> & lt; strong>方法:& lt; / strong>在一项回顾性队列研究中，2017年在生殖内分泌科接受体外受精或ICSI周期的256名患者的所有新鲜周期。对沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城不孕不育科/妇产科进行了随访。他们开始服用促性腺激素药物治疗卵巢过度刺激，随后每次随访连续经阴道U/S和血清雌激素水平。有2个或更多的18mm卵泡的患者在10,000 IU的hCG刺激下，在34-36小时后取卵。 Data were collected on patients’ characteristics [age, BMI infertility type], cycles’ characteristics [number of follicles and endometrium thickness on hCG day, P4 and estrogen levels], rates of pregnancy and pregnancy outcomes. Receiver operating characteristic curve was applied to determine the cut-off of P4 that corresponds with a negative pregnancy test. Logistic regression analysis was used and significance was considered at p - value of ≤0.05.</p> <p><strong>Results: </strong>Pregnancy rate in the study sample was 36.7%. The mean P4 level in cycles with negative pregnancy tests was significantly higher than the mean in cycles with positive tests (p = 0.018). After adjusting for confounders, significant negative association between P4 and pregnancy rate was evident (p < 0.03). The optimum trade-off of P4 for prediction of a negative pregnancy test was 1.5nmol/L. This cut-off level had a 59% sensitivity, 51% specificity and 68% positive predictive value and 10% & 15% absolute and relative risk reductions respectively. Cycles with mean P4 of ≥1.5nmol/L were significantly associated with primary infertility (p = 0.011), lower mean BMI (p = 0.009) higher mean estrogen level (p < 0.001), lower live birth rate (p = 0.048), higher abortion rate (p = 0.039), and higher ovarian hyperstimulation rate (p = 0.027).</p> <p><strong>Conclusion:</strong> Premature elevation of progesterone level on the hCG day in IVF/ICSI cycles may have adversely impacted the pregnancy rate and pregnancy outcome. The cutoff point of 1.5nmol/L for this P4 was not valid in predicting pregnancy outcomes.</p>
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2019-09-11
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