目的 探讨甲状腺功能正常的女性中血清促甲状腺激素(TSH)水平和 IVF/ICSI 早期胚胎丢失的相关性.方法 回顾性分析 2016 年 9 月至 2017 年 2 月本中心拟行 IVF/ICSI中甲状腺功能正常女性患者的临床资料,根据血清 TSH水平,分为TSH≤2.5 mU/L组(830 例)和TSH＞2.5 mU/L组(355 例),对所有患者的甲状腺功能、早期临床妊娠结局及早期胚胎丢失率进行了随访和分析. 结果 本研究共纳入 1 185 例进行 IVF/ICSI助孕、且甲状腺功能正常的女性患者.830例TSH≤2.5 mU/L组患者中,48 例(5.8%)发生早期胚胎丢失,441 例(53.1%)获得临床妊娠,12 例(1.4%)发生异位妊娠;355 例TSH＞2.5 mU/L组患者中,21 例(5.9%)发生早期胚胎丢失,175 例(49.3%)获得临床妊娠,3 例(0.8%)发生异位妊娠,两组数据差异均无统计学意义(P＞0.05). 结论 在行IVF/ICSI的控制性促排卵(COH)前,患者TSH水平高于2.5 mU/L并不造成早期胚胎丢失率增高.%Objective:To explore the association between TSH level and early embryo loss in IVF/ICSI. Methods: The clinical data of the female patients with normal thyroid function in IVF/ICSI from September 2016 to February 2017 were retrospectively analyzed.According to the serum TSH level,the women were divided into two groups:TSH≤2.5 mU/L group(n=830)and TSH＞2.5 mU/L group(n=355).The thyroid function,early clinical pregnancy outcome,and early embryo loss were followed-up and analyzed in all patients. Results:A total of 1 185 women with IVF/ICSI assisted pregnancy and normal thyroid function were included in the study.In the serum TSH≤2.5 mU/L group(n=830),441(53.1%)women had got clinical pregnancy,48(5.8%)women had early pregnancy loss and 12(1.4%)ectopic pregnancy.In the TSH＞2.5 mU/L group(n=355),175(49.3%)women had got clinical pregnancy,21(5.9%)women had early pregnancy loss and 3 (0.8%)ectopic pregnancy.No significant difference were revealed between the two groups(P＞0.05). Conclusions:Serum TSH levels of more than 2.5 mU/L prior to controlled ovarian hyperstimulation in IVF/ICSI do not cause an increase in early embryonic loss.
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