摘要
目的:探讨辅助生殖技术治疗后多胎妊娠的影响因素。方法:研究纳入2013年1月—2016年12月在南京医科大学第一附属医院、南京医科大学附属妇产医院、郑州大学第三附属医院和中国医科大学附属盛京医院生殖中心接受辅助生殖治疗并临床妊娠的患者为研究对象,共计19 434例,其中单胎妊娠14 765例,多胎妊娠4 669例,采用Logistic回归模型分析多胎妊娠的影响因素。结果:在多因素Logistic回归分析中,移植2个胚胎是多胎妊娠最主要的影响因素,与单胎妊娠相比,比值比(OR)36.54,95%置信区间(CI):27.89～47.86。年龄、周期类型、人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)日孕酮水平、获卵数、移植胚胎阶段、累计胚胎评分与双胚胎移植后多胎妊娠相关,OR(95%CI)分别为0.62(0.55～0.70)、0.84(0.77～0.92)、0.86(0.80～0.92)、1.21(1.12～1.31)、1.28(1.13～1.46)、1.19(1.15～1.23)。单胚胎移植后,仅高累计胚胎评分与多胎妊娠风险降低有关(OR:0.68;95%CI:0.47～0.99)。结论:移植胚胎数、年龄、周期类型、hCG日孕酮水平、获卵数、移植胚胎阶段、累计胚胎评分是辅助生殖治疗后多胎妊娠的影响因素。
Objective:This study aims to explore the influencing factors of multiple pregnancies following assisted reproductive technology.Methods:The study included 19 434 embryo transferred cycles(14 765 singleton pregnancy cycles,4 669 multiple pregnancy cycles)resulted in clinical pregnancy from four reproductive centers in China(the First Affiliated Hospital of Nanjing Medical University,the Obstetrics and gynecology Hospital Affiliated to Nanjing Medical University,the Third Affiliated Hospital of Zhengzhou University,and the Shengjing Hospital of China Medical University),during January 2013 and December 2016.Logistic regression model was used to analyze the related factors of the occurrence of multiple pregnancies.Result:In multivariable logistic regression analysis,transplanting two embryos was the major factor in multiple pregnancies,and the odds ratio(OR)compared with single embryo transfer was 36.54,95%confidence interval(CI):27.89~47.86.Age,cycle type,progesterone level on hCG trigger day,number of oocytes retrieved,stage of embryo transferred and cumulative embryo score were associated with multiple pregnancies from double embryo transfer(OR(95%CI)were:0.62(0.55~0.70),0.84(0.77~0.92),0.86(0.80~0.92),1.21(1.12~1.31),1.28(1.13~1.46),1.19(1.15~1.23),respectively)High cumulative embryo score was the only factor associated with decreased risk of multiple pregnancies from single embryo transfer(OR:0.68;95%CI:0.47~0.99).Conclusion:Number of embryos transferred,age,cycle type,progesterone level on hCG trigger day,number of oocytes retrieved,stage of embryo transferred and cumulative embryo score were identified as related factors of multiple pregnancies following assisted reproductive technology.
作者
刘丰
刁飞扬
凌秀凤
管一春
谭季春
吕红
杜江波
沈洪兵
胡志斌
Liu Feng;Diao Feiyang;Ling Xiufeng;Guan Yichun;Tan Jichun;Lv Hong;Du Jiangbo;Shen Hongbing;Hu Zhibin(School of Public Health,Nanjing Medical University,Nanjing 211166;State Key Laboratory of Reproductive Medicine,Nanjing Medical University,Nanjing 211166;Department of Reproduction,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Department of Reproduction,the Affiliated Obstetrics and Gynaecology Hospital of Nanjing Medical University,Nanjing 210004;Department of Reproduction,Henan Medical Maternity and Child Health Care Hospital,Zhengzhou 450052;Department of Reproduction,Shengjing Hospital of China Medical University,Shenyang 110022,China)
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2019年第5期762-768,共7页
Journal of Nanjing Medical University(Natural Sciences)
基金
国家重点研发计划(2016YFC1000200)
国家自然科学基金(81602927)
江苏省自然科学基金(BK20161031)
关键词
辅助生殖技术
胚胎移植
多胎妊娠
相关因素
assisted reproductive technology
embryo transfer
multiple pregnancies
relevant factor
作者简介
通信作者:胡志斌,E-mail:zhibin_hu@njmu.edu.cn。
