摘要
目的 探讨血清βHCG增幅对IVF早期妊娠结局的预测价值。方法 选择体外受精-胚胎移植患者126例，按照妊娠结局进行分组，对胚胎移植14至21天内血清βHCG平均每日增长幅度与早期妊娠结局的相关性进行回顾性分析。采用ROC曲线确定不同妊娠结局在胚胎移植后14至21天内βHCG平均上升幅度的临界点。结果 （1）生化妊娠组血清βHCG达到某一临界点后成负增长；（2）ROC曲线诊断持续和非持续妊娠的临界点为665.45mIU/ml/天，灵敏度0.81，特异度0.79；（3）ROC曲线诊断单胎和双胎持续妊娠的临界点为2017.97mIU/ml/天，灵敏度0.78，特异度0.72 ；（4）ROC曲线诊断单胎持续妊娠和不良妊娠的临界点为602.66mIU/ml/天，灵敏度0.83，特异度0.65 。结论 胚胎移植术后14至21天内，βHCG平均每日增长幅度可预测生化妊娠和正常持续妊娠，区分单胎和双胎持续妊娠，对判断早期妊娠结局有一定的临床意义。
关键词： βHCG；胚胎移植；妊娠结局
Abstract
Objective To investigate the predictive value of serum βHCG increase in early pregnancy outcome in IVF-ET. Methods A total of 126 patients with IVF-ET were selected and divided into groups according to pregnancy outcomes. The correlation between the average daily increase of serum βHCG during 14 to 21 days of embryo transfer and the outcome of early pregnancy was retrospectively analyzed. ROC curves were used to determine the cut-off points for the mean increase in βHCG within 14 to 21 days after embryo transfer for different pregnancy outcomes. Results (1) Most of the biochemical pregnancy groups had negative growth; (2) The critical point of ROC curve for diagnosing persistent and non-persistent pregnancy was 665.45 mIU/ml/day, with a sensitivity of 0.81 and a specificity of 0.79; (3) ROC curve for the diagnosis of singleton The critical point of continuous pregnancy and twin pregnancy is 2017.97mIU/ml/day, the sensitivity is 0.78, the specificity is 0.72; (4) The critical point of ROC curve for the diagnosis of singleton continuous pregnancy and adverse pregnancy is 602.66mIU/ml/day, the sensitivity is 0.83, The specificity was 0.65. Conclusion During 14 to 21 days after embryo transfer, the average daily increase rate of βHCG can predict biochemical pregnancy and normal persistent pregnancy. It is of certain clinical significance to distinguish single pregnancy from twin persistent pregnancy, and to judge the outcome of early pregnancy.
Key words： βHCG; embryo transfer; pregnancy outcome
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