体外受精-胚胎移植后双次血清β-HCG对妊娠结局的预测价值

目的:探讨体外受精-胚胎移植(IVF/ICSI-ET)后14天及18天双次血清β-人绒毛膜促性腺激素(β-HCG)预测妊娠结局的意义。方法:回顾分析2006年1月至2007年5月在我中心行新鲜周期IVF/ICSI-ET助孕后有14天及18天血清β-HCG水平的1154个周期,并追踪妊娠结局。结果:血清β-HCG水平与妊娠结局相关。移植后14天、18天继续妊娠组血清β-HCG值均高于不良妊娠组(P<0.05);而两组的上升幅度无显著性差异(P>0.05)。多胎组血清β-HCG值高于单胎组(P<0.05);单胎组血清β-HCG值高于流产组(P<0.05);流产组和异位妊娠组的血清β-HCG值均高于生化妊娠组(P<0.05);而流产组血清β-HCG值与异位妊娠组无显著性差异(P>0.05)。有233例患者移植14天抽血检测β-HCG<5IU/L后18天未抽血检测β-HCG,追踪随访有7例患者妊娠,早期流产率为85.71%(6/7),继续妊娠率为14.29%(1/7)。结论:IVF-ET后双次血清β-HCG值对早期妊娠结局有较好的预测价值,有助于临床及早期鉴别诊断。

The predictive value of the double serum β-human chorionic gonadotropin in pregnancies outcome following IVF/ICSI-ET

Objective：To deiennine the predictive value of serum β-human chorionic gonadotropin（β-HCG） in pregnancy outcome 14 days and 18 days after in vitro fertilization/intmcytoplasmic sperm injection-embryo transfer（IVF/ICSI-ET）. Methods：The pregnancy outcomes and the serum β-HCG levels of 14 days and 18 days after fresh cycle IVF/ICSI-ET were retrospectively ana- lyzed, Results.The levels of serum β-HCG were correlated with the pregnancy outcome. The serum β-HCG levels of persistent pregnancies were significantly higher than those of poor pregnancies（P 〈 0.05） ,there was no significant difference in the rising range of serum β-HCG 18 days after embryo transfer tested between the two groups（P 〉0. 05）. The serum β-HCG levels of multiple pregnancies were significantly higher than those of singleton pregnancies（P 〈0.05） ;the serum β-HCG levels of singleton pregnancies were significantly higher than these of abortions（P 〈0.05）and levels of abortions were significantly higher than those of biochemical pregnancies （P 〈 0.05） ;but the serum β-HCG levels were not significantly different between abortions and ectopic pregnancies. In 233 patients whose serum β-HCG 〈5IU/L after embryo transfer 14 days,7 patients were pregnancy,the rate of abortion was 85.71% （6/7）,the rate of persistent pregnancies was 14.29% （1/7）. Conclusion：The double serum β-HCG after IVF-ET is an effective predictor for early pregnancy outcome, which may help to predict the differential diagnosis.