天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (3): 301-304.doi: 10.11958/20202454

• 临床研究 • 上一篇    下一篇

基于倾向性评分匹配法探讨子宫腺肌症对体外受精-胚胎移植临床结局的影响

刘敏1，罗海宁2，张印峰2，张博伦3，杨泽欣1，张云山2△   

  1. 1天津医科大学研究生院（邮编300070）；2天津市中心妇产科医院生殖医学中心，天津市人类发育与生殖调控重点实验室；3南开大学研究生院
  • 收稿日期:2020-09-02 修回日期:2020-12-29 出版日期:2021-03-15 发布日期:2021-03-15
  • 通讯作者: 张云山 E-mail:tjzys@hotmail.com
  • 作者简介:刘敏（1993），女，硕士在读，主要从事辅助生殖方面研究。E-mail：liuminhaobang@163.com

Study on the effect of adenomyosis on the clinical outcomes of in vitro fertilization-embryo transfer based on propensity score matching method

LIU Min1, LUO Hai-ning2, ZHANG Yin-feng2, ZHANG Bo-lun3, YANG Ze-xin1, ZHANG Yun-shan2△   

  1. 1 Postgraduate of Tianjin Medical University, Tianjin 300070, China; 2 Reproductive Medicine Center of Tianjin Central Hospital of Gynecology Obstetrics, Tianjin Key Laboratory of Human Development and Reproduction Regulation; 3 Postgraduate of Nankai University
  • Received:2020-09-02 Revised:2020-12-29 Published:2021-03-15 Online:2021-03-15

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摘要： 目的　采用倾向性评分匹配（PSM）法探讨子宫腺肌症对体外受精-胚胎移植（IVF-ET）临床结局的影响。方法　回顾性分析行IVF-ET的女性740例，其中子宫腺肌症患者134例（子宫腺肌症组），单纯输卵管因素不孕的患者606例（对照组）。基于年龄、不孕年限、体质量指数（BMI）、基础雌激素水平对2组患者进行1∶1倾向性评分匹配（PSM），匹配后2组各96例。比较匹配前后2组基线特征、助孕结局和妊娠结局的差异。结果　PSM匹配前后，与对照组相比，子宫腺肌症组促性腺激素（Gn）总量升高，人绒毛膜促性腺激素（HCG）日雌二醇（E2）水平下降（P＜0.05）。助孕结局方面子宫腺肌症组获卵数、成熟卵子数、正常受精数、可利用胚胎数、冷冻胚胎数均较对照组下降（均P＜0.05）。临床结局方面子宫腺肌症患者的活产率显著降低（均P＜0.05）。结论　子宫腺肌症与IVF-ET的不良妊娠结局有关。

关键词: 子宫腺肌病, 体外受精, 胚胎移植, 妊娠结局, 倾向性评分匹配

Abstract: Objective　To explore the effect of adenomyosis on the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) by using propensity score matching (PSM) method. Methods　A total of 740 women underwent IVF-ET were retrospectively analyzed. Among them, there were 134 patients with adenomyosis (adenomyosis group) and 606 patients with infertility due to fallopian tube factors (control group). Based on age, years of infertility, body mass index (BMI) and basic estrogen level, the two groups of patients were matched with 1∶1 propensity score matching (PSM). After matching, there were 96 cases in each of the two groups. The differences in baseline characteristics, fertility outcomes and pregnancy outcomes before and after matching were compared between the two groups. Results　Before and after PSM matching, the dosage of gonadotropin (Gn) was increased, and the daily estradiol (E2) level of human chorionic gonadotropin (HCG) was decreased in the adenomyosis group compared with those of the control group (P＜0.05). In terms of the outcomes of assisted pregnancy, the number of oocytes retrieved, the number of mature oocytes, the number of oocytes normally fertilised, the number of available embryos and the number of frozen embryos were significantly lower in the adenomyosis group than those in the control group (P＜0.05). Conclusion　Adenomyosis is related to the adverse pregnancy outcomes of IVF-ET.

Key words: adenomyosis, fertilization in vitro, embryo transfer, pregnancy outcome, propensity score matching