Association between uterine volume and pregnancy outcomes in adenomyosis patients undergoing frozen-thawed embryo transfer
Association between uterine volume and pregnancy outcomes in adenomyosis patients undergoing frozen-thawed embryo transfer
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DOI：
10.1016/j.rbmo.2020.10.002
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发表时间：
2021-02-12
影响因子：
4
通讯作者：
Ma, Caihong
中科院分区：
文献类型：
--
作者：
Li, Xiaoxue;Pan, Ningning;Ma, Caihong
研究问题：子宫腺肌病患者冷冻-解冻胚胎移植（FET）前子宫体积与生殖结局之间的关系是什么？设计图：回顾性分析了在一家三级学术医院接受IVF和FET的子宫腺肌病患者的临床特征和结局。仅包括第一个囊胚移植周期。主要结果指标包括临床妊娠率（CPR）、流产率和活产率（LBR）。结果：共纳入158例子宫腺肌病患者。受试者工作特征（ROC）曲线分析显示FET前子宫体积与LBR呈负相关，曲线下面积为0.622（95%可信区间[CI] = 0.531 ~ 0.712，P = 0.012）。曲线的截止值为98.81 cm 3。A组83例，子宫体积98.81cm ~ 3;两组患者CPR无显著性差异。B组流产率为51.28%，明显高于A组的16.28%（P = 0.001）。B组LBR为25.33%，明显低于A组的43.37%（P = 0.020）。Logistic回归分析显示，在调整潜在的混杂因素后，FET前子宫体积与CPR无关（优势比[OR] 1.149，95%CI 0.577-2.286，P = 0.693），但与流产率呈正相关（OR 8.509，95%CI 2.290-2.575，P = 0.001）。结论：FET前子宫体积较大（>98.81 cm 3）的子宫腺肌病患者，由于流产率较高，可能具有较低的LBR。建议在进行FET手术前减少子宫体积。
Research question: What is the relationship between uterine volume before frozen-thawed embryo transfer (FET) and reproductive outcomes among adenomyosis patients? Design: Clinical characteristics and outcomes of adenomyosis patients undergoing IVF and FET in a tertiary academic hospital were retrospectively analysed. Only first blastocyst transfer cycles were included. The main outcome measures included clinical pregnancy rate (CPR), miscarriage rate and live birth rate (LBR). Results: A total of 158 adenomyosis patients were enrolled. Receiver operating characteristic (ROC) curve analysis indicated that uterine volume before FET was negatively related to LBR, with area under the curve of 0.622 (95% confidence interval [CI] = 0.531-0.7 12, P = 0.012). The cut-off value for the curve was 98.81 cm3. Grouped by the cut-off of uterine volume, 83 women were included in group A (98.81 cm3). No significant difference was found in CPR between two groups. Compared with group A, the incidence of miscarriage in group B was significantly increased (51.28% versus 16.28%, P = 0.001). LBR in group B was markedly lower than in group A (25.33% versus 43.37%, P = 0.020). Logistic regression analysis revealed that, after adjusting for potential confounders, uterine volume before FET was not associated with CPR (odds ratio [OR] 1.149, 95% CI 0.577-2.286, P = 0.693) but was positively related to miscarriage rate (OR 8.509, 95% CI 2.290-2.575, P = 0.001). Conclusions: Adenomyosis patients with larger uterine volume (>98.81 cm3) before FET might have a lower LBR due to higher incidence of miscarriage. Reduction of uterine volume before embarking on FET procedures should be recommended.