摘要
目的:基于临床资料分析试管婴儿辅助助孕妊娠结局的影响因素,并构建预测模型。方法:回顾性分析283例不孕症患者的临床资料。根据患者的妊娠结局将其分为妊娠成功组(147例)和妊娠失败组(136例)。采用多因素Logistic回归分析影响因素;绘制受试者工作特征(ROC)曲线评估预测价值;基于多因素Logistic回归分析结果构建预测模型并进行验证。结果:283例不孕症患者接受试管婴儿辅助助孕治疗后,147例成功妊娠,妊娠成功率为51.94%(147/283)。妊娠失败组不孕症的发生年限>3年比例、HCG注射日子宫内膜形态B型或C型比例、子宫内膜厚度<7 mm比例、胚胎质量不佳比例均高于妊娠成功组(P<0.05)。子宫内膜厚度<7 mm、HCG注射日子宫内膜形态为B型或C型、合并不孕症的发生年限>3年、胚胎质量不佳是试管婴儿辅助助孕妊娠失败的危险因素(P<0.05)。绘制ROC曲线分析结果显示,HCG注射日子宫内膜形态、不孕症的发生年限、子宫内膜厚度及胚胎质量单独预测试管婴儿辅助助孕妊娠失败的曲线下面积(AUC)分别为0.577、0.617、0.581、0.603。基于试管婴儿辅助助孕妊娠失败的影响因素构建多因素Logistic回归模型,该模型预测试管婴儿辅助助孕妊娠失败的AUC为0.845,其预测效能高于各影响因素单独应用(Z=6.832、5.905、6.832、6.258,P均<0.05)。结论:子宫内膜厚度<7 mm、HCG注射日子宫内膜形态为B型或C型、合并不孕症的发生年限>3年、胚胎质量不佳是试管婴儿辅助助孕妊娠失败的危险因素,基于上述危险因素构建的预测模型对试管婴儿辅助助孕妊娠结局具有较高的预测价值。
Objective:To analyze the influencing factors of pregnancy outcome of test-tube baby assisted pregnancy base on clinical data,and build a prediction model.Methods:The clinical data of 283 infertility patients were retrospectively analyzed.They were divided into successful pregnancy group(147 cases)and failed pregnancy group(136 cases)according to the pregnancy outcome.The influencing factors of pregnancy were analyzed by multivariate Logistic regression analysis.The predictive value of influencing factors was evaluated by drawn receiver operating characteristic(ROC)curve.Prediction model was constructed and verified based on the results of multivariate Logistic regression analysis.Results:283 cases of infertility patients received test-tube baby assisted pregnancy treatment,147 cases were successfully pregnant,and the pregnancy success rate was 51.94%(147/283).The proportion of the duration of infertility>3 years,the proportion of endometrial morphology on HCG injection day was B or C,the proportion of endometrial thickness<7 mm,and the proportion of embryo quality not good in failed pregnancy group were higher than those in successful pregnancy group(P<0.05).Endometrial thickness<7 mm,endometrial morphology on HCG injection day was B or C,the duration of infertility>3 years,embryo quality not good were the risk factors for the failure of test-tube baby assisted pregnancy(P<0.05).The results of ROC curve analysis showed that,the area under the curve(AUC)of endometrial morphology on HCG injection day,the duration of infertility,endometrial thickness and embryo quality to predict the failure of test-tube baby assisted pregnancy were 0.577,0.617,0.581 and 0.603 respectively.Multivariate Logistic regression model was constructed based on the influencing factors of failure of test-tube baby assisted pregnancy,the AUC of this model for predicting failure of test-tube baby assisted pregnancy was 0.845,and its predictive efficacy was higher than that of each influencing factor alone(Z=6.832,5.905,6.832,6.258,all P<0.05).Conclusion:Endometrial thicknes<7 mm,endometrial morphology on HCG injection day was B or C,the duration of infertility>3 years,embryo quality not good are risk factors for the failure of test-tube baby assisted pregnancy,the prediction model base on the above risk factors has a high predictive value for the pregnancy outcome of test-tube baby assisted pregnancy.
作者
黄彦妮
李顺
韦静
HUANG Yan-ni;LI Shun;WEI Jing(Department of Reproductive Medicine,Liuzhou People's Hospital,Liuzhou,Guangxi,545006,China)
出处
《现代生物医学进展》
2025年第12期2048-2054,共7页
Progress in Modern Biomedicine
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190053)。
关键词
临床资料
试管婴儿
辅助助孕
不孕症
妊娠结局
预测模型
Clinical data
Test-tube baby
Assisted pregnancy
Infertility
Pregnancy outcome
Predictive model
作者简介
黄彦妮(1975-),女,硕士,副主任医师,主要研究方向:生殖医学,E-mail:13597263060@139.com。
