天津医药

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I VF-ET过程中流产因素分析

王俊超1,徐凤琴1,罗海宁1,马俊芳1,张云山2   

  1. 1. 天津市中心妇产科医院
    2. 天津市中心妇产科医院生殖医学中心
  • 收稿日期:2011-03-03 修回日期:2012-02-06 出版日期:2012-07-15 发布日期:2012-07-15
  • 通讯作者: 罗海宁

Causes Analysis of Abortion during IVF-ET Treatment

  • Received:2011-03-03 Revised:2012-02-06 Published:2012-07-15 Online:2012-07-15

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摘要： 摘要 目的：探讨在IVF-ET过程中引起患者流产的因素，从而更好的提高临床妊娠率，减少和预防流产的发生。方法：选择2005年1月1日-2009年12月31日在行IVF-ET患者共3117例，临床妊娠患者1195例，其中流产患者203例，包括早期流产患者150例，为早期流产组，晚期流产患者53例，为晚期流产组。分别对两组患者年龄、体重指数(BMI)、COH情况以及妊娠情况进行分析，寻找导致IVF-ET治疗过程中患者临产的相关因素。结果：本中心IVF临床妊娠率为38.3%，流产率为16.9%，其中早期流产率为12.6%，晚期流产率为4.4%。早期流产组患者ET后14天血. β-hCG水平较低，晚期流产患者BMI较高、减胎及双胎妊娠率高。结论：早期流产多与胚胎本身发育异常有关，ET后14天血hCG水平偏低提示有胚胎发育差、早期流产的风险高的可能。另外高BMI以及应用大剂量Gn超排卵有可能影响子宫内膜的容受性，影响胚胎着床。而多胎妊娠和减胎术容易导致胎膜早破，可能是造成晚期流产的一个重要因素，另外胎儿畸形行引产术也是导致晚期流产的另一个重要因素。

关键词: 流产, 病因学, 体外受精-胚胎移植

Abstract: Abstract Objective: to investigate the causes of abortion during IVF-ET in order to increasing the pregnancy rate and preventing the occurance of abortion. Methods: 203 patients including 150 patients who had early stage abortion (early abortion group) and 53 patients who had late stage abortion (late abortion group ) were enrolled. The age, BMI, COH and clinical pregnancy results between the two groups were analysed in order to find the causes of spontaneous abortion during IVF-ET treatment. Results: The clinical pregnancy rate in our center is 38.3% while the 16.9% including early abortion rate 12.6 % and late abortion rate 4.4%,.The β-hCG level of 14 days after ET is quite low in the early abortion group while the BMI, Multiple pregnancy and fetal reduction method in late abortion group is high. Conclusion: early abortion is correlated with embryo quality and more than 60% is due to the chromosome abnormalities. Low level of hCG after 14 days of ET will suggest the high risk of early abortion. Additionally increasing BMI and large dose of Gn during COH can infect the receptivity of the endometrium and the embryo implantation. Multiple pregnancy and fetal reduction method can cause prematue membrane rupture and is one of the reason causing late stage abortion. More over fetal malformation is another reason for pregnancy induction.

Key words: abortion, aetiology, IVF-ET