体外受精-胚胎移植（IVF-ET）术后早期流产患者的相关因素分析

目的：探讨体外受精-胚胎移植( IVF-ET)术后早期流产患者的相关因素分析。方法选择2013年1月—2015年6月广西妇幼保健院生殖中心首次实施常规体外受精和卵母细胞内单精子显微注射后行新鲜胚胎移植获得妊娠的孕妇236例，根据妊娠后的结局不同进行分组，其中自然流产组42例，继续妊娠组194例。观察两组孕妇的年龄、不孕年限、基础内分泌、促性腺激素( Gn)使用天数、Gn使用总量、获卵个数、受精方式、子宫内膜厚度等指标，分析影响早期流产的因素。结果实施辅助生殖技术助孕早期流产发生率为12.50%。两组不孕年限、自然流产数、人工流产数、BMI、取卵日子宫内膜厚度、窦卵泡数、优胚数、胚胎移植( ET)数、Gn使用天数比较，差异无统计学意义(P>0．05)，年龄、卵泡生成激素/黄体生成激素(FSH/LH)比值、获卵泡数、Gn使用量差异有统计学意义(P<0．05)。多因素回归分析结果显示孕妇年龄和FSH/LH比值为IVF-ET术后早期流产的危险因素。结论导致IVF-ET术后早期自然流产有多方面原因，尤其与年龄、激素水平有关。针对不同年龄患者，需制订个体化治疗方案，密切监测妊娠后激素水平等，以降低早期自然流产的发生率。

Analysis of Related Factors for Early Abortion Patients after in Vitro Fertilization-embryo Transfer

Objective To analyze related factors of early abortion patients after in vitro fertilization-embryo transfer ( IVF-ET) . Methods A total of 236 pregnant women during January 2013 and June 2015 were chosen, who re-ceived their first IVF and were pregnant after fresh embryo transfers by single spermatozoa microinjection. All pregnant women were divided into spontaneous abortion group (n=42) and pregnant group (n=194) according to pregnancy out-come. Indexes such as age, infertility time, basic endocrine, days of gonadotrophin ( Gn) use, total dose of Gn, num-bers of obtained oocytes, fertilized ways and endometrium thickness were analyzed in two groups. Results Incidence rate of early abortion after pregnancy with assisted technology was 12. 50%. There were no significant differences in infer-tility time, frequency of spontaneous abortion and induced abortion, body mass index ( BMI) , endometrium thickness on the day of obtained oocytes, antral follicle count, numbers of good embryos and ET and days of Gn use (P>0. 05), and the differences in age, numbers of obtained oocytes and total dose of Gn were statistically significant in two groups ( P<0. 05). Multivariate regression analysis showed that age and value of follicle-stimulating hormone/luteinizing hormone ( FSH/LH) of pregnant women were independent risk factors of early abortion. Conclusion Many factors can induce early spontaneous abortion after IVF-ET, especial age and hormonal level. To make more individualized treatment meth-ods for pregnant women among different age groups, and hormonal levels after pregnancy should be close monitored in or-der to reduce incidence rate of early abortion.