Risk Factors and Early Predictors for Heterotopic Pregnancy after In Vitro Fertilization.
Risk Factors and Early Predictors for Heterotopic Pregnancy after In Vitro Fertilization.
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体外受精后异位妊娠的危险因素和早期预测因素
DOI：
10.1371/journal.pone.0139146
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Chen ZJ
中科院分区：
文献类型：
--
作者：
Liu M;Zhang X;Geng L;Xia M;Zhai J;Zhang W;Zhang Y;Sun Y;Zhang J;Zhu D;Zhao H;Chen ZJ
本研究探讨了体外受精和胚胎移植（IVF-ET）后异位妊娠（HP）的危险因素和早期预测因素。回顾性分析2008年1月~ 2013年1月IVF-ET术后41例HP和72例宫内双胎妊娠。与宫内双胎妊娠组相比，HP组基础黄体生成素（LH）水平较低（P = 0.005），有输卵管积水史的病例较多（P = 0.008）。体外受精14 d后，HP组血清β-HCG （β-人绒毛膜促性腺激素）、E2（雌二醇）和P（孕酮）水平均降低（P<0.001）。此外，阴道出血和腹痛是HP诊断前的显著特征（P<0.001）。进一步通过logistic回归，确定ET后第14天血清β-hCG、P水平和阴道出血为HP的独立因素。这些结果表明，当体外受精过程中移植两个或两个以上的胚胎时，β-hCG、ET后第14天P水平和阴道出血可作为HP的预测因素。
This study investigated the risk factors and early predictors for heterotopic pregnancy (HP) after in vitro fertilization and embryo transfer (IVF-ET). From January 2008 to January 2013, 41 cases of HP and 72 cases of intrauterine twin pregnancy after IVF-ET were recruited and retrospectively analyzed. Compared with intrauterine twin pregnancy group, the HP group had a lower basal luteinizing hormone (LH) level (P = 0.005) and more cases had a history of hydrosalpinx (P = 0.008). After 14 days of IVF-ET, the serum β-HCG (β-human chorionic gonadotropin), E2 (Estradiol) and P (Progesterone) levels were lower in HP group (P<0.001, respectively). Moreover, vaginal bleeding and abdominal pain were the significant features of HP before diagnosis (P<0.001, respectively). Further by logistic regression, serum β-hCG, P levels on the 14th day after ET, and vaginal bleeding were identified as the independent factors of HP. These results indicate that when two or more embryos transferred in IVF procedure, β-hCG, P levels on the 14th day after ET, and vaginal bleeding could be taken as predictors for HP.