激活素和抑制素A在预测ART后未知部位妊娠结局中的作用

Juan Giles, Carmen Vidal, Antonio Pellicer, Ernesto Bosch
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摘要

目的是探讨激活素a和抑制素a的单一血清测定对IVF周期后自己的新鲜卵母细胞和捐赠卵母细胞中未知位置妊娠(PUL)分类的预测价值。在大学附属试管婴儿中心进行的病例对照研究。自体卵母细胞后妊娠结局包括12例宫内妊娠失败,12例宫内妊娠(EP)和对照组24例单胎宫内妊娠(IUP)。卵母细胞捐赠受者采用相同的方案。测定抑制素A、激活素A、β-hCG、孕酮(P)。在自身新鲜卵母细胞体外受精中,预测EP与PUL失败的AUC分别为:激活素A: 0.458和抑制素A: 0.60。在卵母细胞捐赠周期中,预测EP的AUC分别为:激活素A: 0.521,抑制素A: 0.906。我们的结果不能外推到自然受孕,因为与自然周期相比,人工排卵后这些生物标志物的一些值更高。有必要继续寻找一种能准确预测妊娠进化的生物标志物。
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Activin and inhibin A in predicting outcome of pregnancies of unknown location after ART

The aim was to investigate the predictive value of a single serum determination of activin A and inhibin A for classifying pregnancies of unknown location (PUL) after IVF cycles in both own fresh and donated oocytes. A case–control study conducted in a University-affiliated IVF center. Pregnancy outcomes after own fresh oocytes included 12 failing PUL, 12 ectopic pregnancies (EP) and a control group of 24 singleton intrauterine pregnancies (IUP). The same scheme was followed for the oocyte donation recipients. Inhibin A, activin A, β-hCG and Progesterone (P) were determined. In the own fresh oocytes IVF, the AUC for predicting EP vs. f failing PUL were: Activin A: 0.458 and Inhibin A: 0.60. In the oocyte donation cycles, the AUC for predicting EP were: Activin A: 0.521 and Inhibin A: 0.906. Our result cannot be extrapolated to spontaneously conceived pregnancies, since values of some of these biomarkers are higher after induced ovulation compared with natural cycle. It will be necessary to continue the search of a biomarker which accurately predict pregnancy evolution.

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