新鲜周期胚胎移植产妇hCG日超生理剂量雌激素水平对胎盘效率的影响及其相关性研究

Effects of supraphysiological estrogen levels on hCG trigger day on placental efficiency and their correlation in women undergoing fresh embryo transfer cycles

摘要

目的 探讨人绒毛膜促性腺激素(hCG)扳机日(简称hCG日)血清超生理剂量雌激素水平对接受新鲜周期胚胎移植(FET)的产妇胎盘效率的影响。方法 收集2022年1月至2024年10月在唐都医院产科经阴道分娩、且曾在唐都医院生殖医学中心接受FET的产妇及其新生儿相关数据,共225例。胎盘效率采用新生儿出生体重与胎盘重量的比值(BW/PW)进行评估,采用双变量相关检验及单因素、多因素线性回归分析进行统计学处理。结果 在总人群中,hCG日雌激素水平与胎盘效率呈显著负相关(相关系数=-0.655,P<0.01);无妊娠并发症组(n=163)中,两者相关系数为-0.680(P<0.01);妊娠并发症组(n=62)中,相关系数为-0.582(P<0.01)。三组人群的单因素及多因素线性回归分析均表明,hCG日雌激素水平对胎盘效率具有负向影响(总人群:β=-0.001,95%CI:-0.001~0.000,P<0.001;无妊娠并发症组:β=-0.001,95%CI:-0.001~0.000,P<0.001;妊娠并发症组:β=-0.001,95%CI:-0.001~0.000,P<0.001)。结论 接受新鲜周期胚胎移植的产妇其hCG日雌激素水平与胎盘效率呈显著负相关,该趋势在总人群、无并发症亚组及合并并发症亚组中均稳定存在。

Abstract

Objective To investigate the effects of supraphysiological serum estrogen levels on the human chorionic gonadotropin (hCG) trigger day on placental efficiency in women undergoing fresh embryo transfer (FET) cycles. Methods Clinical data of women and their neonates were collected from January 2022 to October 2024.All women underwent vaginal delivery at Tangdu Hospital and had previously received FET at the Reproductive Medical Center of Tangdu Hospital.A total of 225 cases were included.Placental efficiency was assessed using the birth weight to placental weight (BW/PW) ratio.Statistical analyses were performed using bivariate correlation analysis as well as univariate and multivariate linear regression analyses. Results In the overall population,serum estrogen levels on the hCG trigger day were significantly negatively correlated with placental efficiency (correlation coefficient=-0.655,P<0.01).In the subgroup without pregnancy complications (n=163),the correlation coefficient was -0.680 (P<0.01),whereas in the subgroup with pregnancy complications (n=62),the correlation coefficient was -0.582 (P<0.01).Both univariate and multivariate linear regression analyses in all three populations demonstrated a negative effect of estrogen levels on the hCG trigger day on placental efficiency (overall population: β=-0.001,95%CI:-0.001-0.000,P<0.001; subgroup without pregnancy complications:β = -0.001,95% CI:-0.001-0.000,P<0.001;subgroup with pregnancy complications: β=-0.001,95%CI:-0.001-0.000,P<0.001). Conclusion In women undergoing FET cycles,serum estrogen levels on the hCG trigger day were significantly negatively correlated with placental efficiency.This trend remained consistent in the overall population,the subgroup without pregnancy complications,and the subgroup with pregnancy complications.

关键词

雌激素 / 胎盘效率 / 新鲜胚胎移植 / 人绒毛膜促性腺激素扳机日

Key words

estrogen / placental efficiency / fresh embryo transfer / hCG trigger day

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基金资助

国家自然科学基金(82271734)

国家自然科学基金(82071717)

国家自然科学基金(82204152)

唐都医院社会人才基金(2021SHRC005)