孕前空腹血糖对体外受精／卵胞浆内单精子注射治疗的妊娠结局的影响

目的本文探究行体外受精一胚胎移植（IVF—ET）／卵胞浆内单精子注射（ICSI）助孕治疗患者孕前空腹血糖值在5．1～6．1mmol／L时是否对妊娠结局有不利影响。方法对2011年7月至2012年3月我院生殖中心拟行IVF／ICSI术患者在胚胎移植前测量空腹血糖，将空腹血糖值5．1～6．1mmol／L者作为实验组（A组，n=244），空腹血糖值〈5．1mmol／L者作为对照组（B组，n=141）。分析比较两组患者注射人绒毛膜促性腺激素（HCG）日卵泡刺激素（FSH）、黄体生成素（LH）、雌激素（E2）水平，回收卵数，优胚率，移植胚胎数，并分析单胎妊娠患者的妊娠结局（妊娠率、远期妊娠率、早期自然流产率、初次剖宫产率、早产率、巨大胎儿发生率等）。结果A、B两组患者妊娠率（52．22％VS．55．00％，P=0．628）、远期妊娠率（47．29% vs．44．17％，P=0．586）、早期自然流产率（9．43％VS．9．09％，P=0．94）、初次剖宫产率（76．04％vs．69．81％，P=0．408）、早产率（11．46％VS．7．55％，P=0．448）、巨大胎儿发生率（9．38％VS．1．89％，P=0．159）均无显著差异。结论孕前空腹血糖浓度5．1～6．1mmol／L时对妊娠结局未产生不利影响。

Influence of borderline fasting plasma glucose levels on pregnancy outcome in IVF/ICSI cycles

Objective： According to the new proposed diagnostic cut-offs for gestational diabetes from International Association of Diabetes and Pregnancy Study Groups（IADPSG）of the American Diabetes Association（ADA） in 2011, we investigate whether the borderline fasting plasma glucose levels（〉 5.1 mmol/L） before IVF/ICSI leads to adverse pregnancy outcome. Methods： A total of 385 patients with IVF/ICSI in our IVF center from July 2011 to March 2012 were divided into the experimental group（group A,n=244）and the control group（group B,n=141）according to the fasting plasma glucose levels（5.1 mmol/L）, and the fasting plasma glucose levels in group A and B were 5.1-6.1 mmol/L and 5.1 mmol/L respectively. Major outcome measures were clinical pregnancy rate, ongoing pregnancy rate, early spontaneous abortion rate, primary cesarean section rate, preterm delivery rate and fetal macrosomia rate in pregnant women who had singleton pregnancy. Secondary outcomes including the levels of FSH, LH and E2 on the day of HCG administration, number of oocytes retrieved, high-quality embryonic rate and embryo transferred embryonic number were measured. Results： There were no significant differences including clinical pregnancy rate（52.22% vs. 55.0%, P= 0. 628 ） , ongoing pregnancy rate （47.29% vs. 44.17%, P= 0. 586）, early spontaneous abortion rate （9.43%vs. 9.09%,P=0.94）,primary cesarean section rate（76.04% vs. 69.81%,P=0.408）,preterm delivery rate（11. 46% vs. 7.55%, P = 0. 448） and fetal macrosomia rate （9.38% vs. 1.89%, P = 0. 159） between the two groups. Conclusions： The borderline levels of fasting plasma glucose（5.1-6.1 mmol/L）before IVF/ICSI do not lead to adverse pregnancy outcome.