亚临床甲状腺功能减退对助孕技术临床结局影响的分层分析
Stratified Analysis of the Effects of Subclinical Hypothyroidism on the Clinical Outcomes of Assisted Pregnancy Techniques
摘要: 目的：探讨亚临床甲状腺功能减退(SCH)对体外受精/卵胞浆内单精子显微注射–胚胎移植(IVF/ICSI-ET)助孕患者妊娠结局的影响。方法：回顾性分析2017年1月至2019年11月在青岛大学附属医院生殖医学中心接受IVF/ICSI-ET治疗患者的资料，按促甲状腺激素(TSH)水平分组，分析亚临床甲状腺功能减退对妊娠结局的影响。结果：本研究共纳入了1087例研究对象，结果显示：1) 不同组患者的获卵总数、正常受精率、可移植胚胎数、优质胚胎率、临床妊娠率、流产率及活产率，均无统计学差异(P > 0.05)，但伴随TSH升高存在优质胚胎率下降的趋势；2) 组间生化妊娠率有显著性差异(P < 0.05)，3.8 < TSH ≤ 4.5组生化妊娠率明显增高。结论：亚临床甲减患者行IVF/ICSI-ET治疗发生生化妊娠率、流产率明显增高，优质胚胎率呈下降趋势。因此需对亚临床甲减患者IVF/ICSI-ET治疗过程及孕期甲状腺功能进无行严密监测，预防不良妊娠结局的发生。
Abstract: Objective: To investigate the effects of subclinical hypothyroidism (SCH) on the clinical outcomes during in vitro fertilization and embryo transfer (IVF/ICSI-ET). Method: The data of patients undergoing IVF/ICSI-ET from January 2017 to November 2019 in the Reproductive Medical Center of the Affiliated Hospital of Qingdao University were analyzed retrospectively. The influence of subclinical hypothyroidism (SCH) on the clinical outcomes was analyzed. Result: 1087 subjects were enrolled in the study. 1) The number of retrieved oocytes, the fertilization rate, high quality embryo rate, the quality of transplantable embryo, the clinical pregnancy rate, the miscarriage rate, and the live birth rate were not significantly different (P > 0.05). But high quality embryo rate reduces as the TSH rises. 2) Biochemical pregnancy rate has a significant statistical difference, and the biochemical pregnancy rate is significantly higher in the 3.8 < TSH ≤ 4.5 group. Conclusion: The biochemical pregnancy rate and miscarriage rate are significantly higher in SCH patients undergoing IVF/ICSI-ET. And high quality embryo rate showed a downward trend. Therefore, it is necessary to pay more attention to the process of IVF/ICSI-ET and thyroid function during pregnancy of patients with subclinical hypothyroidism to prevent the occurrence of adverse pregnancy outcomes.
文章引用：张佳烨, 侯长江, 周鑫, 汤秀明, 丁钰, 刘建新. 亚临床甲状腺功能减退对助孕技术临床结局影响的分层分析[J]. 临床医学进展, 2021, 11(1): 312-318. https://doi.org/10.12677/ACM.2021.111045

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