【摘要】 目的:探讨预防性控制血清促甲状腺素(TSH)水平<2.5mU/L对体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)妊娠早期的影响。方法:因单纯输卵管因素或男方因素不孕初次接受IVF/ICSI-ET治疗的不孕患者181例,在初诊及IVF/ICSI治疗前1个月时检测血清游离甲状腺素(FT4)、促甲状腺素(TSH)水平。满足两次检测2.5mU/L<TSH≤5.0mU/L者随机分为两组,未用左甲状腺素片(L-T4)预治疗的42例为A组,应用L-T4预治疗并维持TSH<2.5mU/L的34例为B组;满足两次检测TSH≤2.5mU/L的105例为C组,比较3组IVF/ICSI-ET结果。结果:3组对象年龄、促性腺激素(Gn)用量、获卵数、内膜厚度、受精率、优胚率、胚胎移植数、生化妊娠率均无统计学差异(P>0.05);A组胚胎种植率和临床妊娠率(27.9%、45.2%)较B组(49.2%、79.4%)、C组(42.9%、65.7%)低,早期流产率(31.6%)较B组(7.4%)、C组(11.6%)高,差异均有统计学意义(P<0.05),B组与C组比较差异均无统计学意义(P>0.05)。结论:对于2.5mU/L<TSH≤5.0mU/L的不孕患者使用L-T4预治疗,使TSH水平维持在<2.5mU/L,对其IVF/ICSI-ET早期妊娠结果有正面影响。更多还原

【Abstract】 Objective:To explore the effect of preventative control of serum thyrotropin levels at less than 2.5mU/L on early pregnancy with in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET).Methods:A study was performed on 181 infertility patients undergoing initial IVF/ICSI-ET because of simple fallopian tubes factor or male factor from March 31,2013 to March 31,2014.The concentrations of serum free thyroxine(FT4)and thyroid-stimulating hormone(TSH)were evaluated at first visit and a month before the beginning of IVF/ICSI-ET treatment.The patients with TSH levels between 2.5mU/L and 5.0mU/L were randomly divided into two groups.Women in group A(n=42)did not use L-thyroxine tablets(L-T4),TSH level in those of group B(n=34)were lowered at less than 2.5mU/L after the use of L-T4,and TSH level in those of group C was not more than2.5mU/L in at least two measures(n=105).The outcomes of IVF/ICSI-ET for each group were compared.Results:Age,gonadotropins dosage,number of oocyte,endometrial thickness,fertilization rate,embryo quality rates,number of embryo transferred and biochemical pregnancy rate had no statistically significant differences among three groups(P>0.05);Embryo implantation rate and clinical pregnancy rate of group A(27.9%,45.2%)were lower than those of group B(49.2%,79.4%)and group C(42.9%,65.7%);Trimester miscarriage rate of group A(31.6%)was higher than those of group B(7.4%)and group C(11.6%),showing statistically significant differences(P<0.05).Conclusion:Patients with TSH levels between 2.5mU/L and 5.0mU/L lowered at less than 2.5mU/L after the prophylactic use of L-T4 has a positive effect on early pregnancy of IVF/ICSI-ET.更多还原