胚胎移植术后妊娠成功的临床影响因素分析

Analysis of Clinical Influencing Factors for Successful Pregnancy after Embryo Transfer

摘要: 目的：探讨影响胚胎移植术后临床妊娠结局的关键因素，重点分析年龄、营养状态及内分泌指标等的独立影响作用，为临床优化助孕策略提供依据。方法：采用单中心回顾性研究设计，收集2022年1月至2025年6月期间接受胚胎移植术的80例患者的临床资料。根据妊娠结局分为妊娠组(n = 38)和未妊娠组(n = 42)。比较两组患者的基线资料，并采用单因素及多因素Logistic回归分析筛选影响临床妊娠的独立因素。结果：单因素分析显示，妊娠组患者的年龄、体质量指数(BMI)及存在营养风险(NRS-2002评分 ≥ 3分)的比例均显著低于未妊娠组(均P < 0.05)。多因素Logistic回归分析进一步证实，年龄 > 35岁(调整后OR = 3.32, 95% CI: 1.20~9.18)、存在营养风险(调整后OR = 5.21, 95% CI: 1.57~17.28)是妊娠失败的独立危险因素，而较高的HCG日雌二醇(E2)水平(调整后OR = 1.01, 95% CI: 1.00~1.02)是保护因素。结论：女性高龄(>35岁)和围移植期存在营养风险是胚胎移植术后妊娠失败的独立危险因素，而适宜的HCG日E2水平有利于妊娠成功。临床应加强对高龄患者的评估，并将营养风险筛查与干预作为提高妊娠率的重要策略。

Abstract: Objective: To explore the key factors influencing clinical pregnancy outcomes after embryo transfer, with a focus on analyzing the independent effects of age, nutritional status, and endocrine indicators, etc., to provide a basis for optimizing assisted reproductive strategies in clinical practice. Method: A single-center retrospective study design was adopted to collect the clinical data of 80 patients who underwent embryo transfer from January 2022 to June 2025. According to the pregnancy outcome, they were divided into the pregnancy group (n = 38) and the non-pregnancy group (n = 42). The baseline data of the two groups of patients were compared, and univariate and multivariate Logistic regression analyses were used to screen the independent factors influencing clinical pregnancy. Result: Univariate analysis showed that the age, body mass index (BMI), and the proportion of patients with nutritional risk (NRS-2002 score ≥ 3 points) in the pregnant group were significantly lower than those in the non-pregnant group (all P < 0.05). Multivariate Logistic regression analysis further confirmed that age > 35 years (adjusted OR = 3.32, 95% CI: 1.20~9.18) and nutritional risk (adjusted OR = 5.21, 95% CI: 1.57~17.28) were independent risk factors for pregnancy failure. A higher level of estradiol (E2) on HCG day (adjusted OR = 1.01, 95% CI: 1.00~1.02) was a protective factor. Conclusion: Advanced female age (>35 years old) and nutritional risks during the peri-transplantation period are independent risk factors for pregnancy failure after embryo transfer, while an appropriate E2 level on HCG day is conducive to successful pregnancy. Clinically, the assessment of elderly patients should be strengthened, and nutritional risk screening and intervention should be regarded as important strategies to improve the pregnancy rate.