Ket qua nghien eiru gdi y rang VKCSKXQ ed the la giai doan sdm eiia VCSDK. Viee ap dung tieu chuan ASAS sd dung xet nghiem HLA-B27 va MRI khdp cung chau cd y nghTa quan trpng giiip chan doan sdm eae benh nhan viem khdp ept sdng d giai doan tien X quang, tCr dd ed ean thiep dieu tri sdm giup nang eao hieu qua dieu tn, giam ganh nang benh tat va nguy cd tan phe ciio ngu'di benh.
TAI LIEU THAM KHAO
1. Corbett M, Soares M, Jhuti G, et al.[20161.
Tumour necrosis factor-a inhibitors for ankvlosina sDondvlitis and non-radioqraDhic axial SDondvloarthritis: a systematic review and economic evaluation. Health Technol Assess;
20f 91:1-334.
2. Kiltz U, Baraliakos X, Karakostas P e t a l , [20121. "Do Dabents with non-radioaraphic axial SDondvlarthritis differ from oatients with ankylosing soondvlitis?" Arthnds Care Res (Hoboken). 64:1415-22.
3. Mau W, Zeidler H. Mau R et al. ri998V Clinical features and orognosis of patients with possible ankvlosinq soondvlitis. Results of a 10-year followup. J Rheumatol, 15:1109-14.
4. Rohekar S, Pope 3 (2010). "Assessment of work disability in seronegative spondyioarthritis". dm EXD Rheumatol. 28(11:35-40.
3. Rudwaleit M, Jurik AG, Hermann KGA, et al.
f2009). "Definina active sacroiliitls on maqnetic resonance imaginq fMRIl for classification of aaal sDOndvloartiiritls: a consensual aooroach bv the ASAS/OMERACr MRI group". Ann Rheum Dis.
68:1520-1527.
o. Rudwaleit M, van der Heijde D, Landewe R, et al. (2009). "Tiie development of Assessment of SpondyloArthritis international Sode^
classification criteria for axial spondyloartiirftis (part II): validation -and final selection". Ann Rheum Dis. 68f6);777-783.
/ . Wallis D, Haroon N.Avearst R,Cartv A, Inman RD [20131. "Ankvlosina Soondvlibs and Nonradionrauhic Axial SDondvloarthritis: Part of a Common Suectrum or Disfinct Diseases?" J Rheumatol. 40:2038-41.
GIA TRI TIEN LITCTNG CUA NONG DO phCG 14 NGAY SAU CHUYEN PHOI DOI V a i SO LirONG T H A I S A U T H U T I N H TRONG ONG NGHIEM
Nguyin Xuan Ho1*,Va Thj Thu Huyin**
Objective: to determine the cut-off point of p- hCG levels in prognosis of number of fetus In vitro fertilization. Subjects: This study conducted in 1078 IVF patients. p-hCG was done on day 14 after embryo transfer and vaginal ultrasound was done on day 28 after embryo transfer. Methods: this was a retrospective, cross-sectional study. Results: The mean level of p-HCG concentration in triplet was 1211.21 ± 779.69 mlU/mL, twin was 934.01 ± 663.99 mlU/mL, singleton was 581.86 ± 670.22 mlU/mL The cut-off level of p-hCG of muldple pregnandes was 600.5 mlU/mL with 71.4% sensltiwty, 69.1% specifidty, AUC = 0.759. Conclusion: The cut-off point of p-hCG level is useful In predicbng multiple pregnandes.
Key word: In Vitro Fertilization, phCG, multiple pregnancies.
I. DAT V ^ N OE
TTiy tinh dng nghiem (IVF - In Vitro Fertilization) la choc hiit mot hay nhieu noan da tru'dng thanh tir buong triitig cho thu tinh vdi tinh trimg (da lpe rira) trong ong nghiem. Sau khi noan thu tinh phat trien thanh phoi, chuyen phoi tot vao buong tir cung d l phoi lam to va phat trien thanh thai nhi. Thong thu'dng, trong thu tinh ong nghiem benh nhan du'dc chuyen nhieu hdn 1 phoi, do vay kha nang cao binh nhan se chiTa da thai. Chira da thai la tinh trang thai nghen nguy cd cao. Cae thai ky chu:a da thai thu'dng lien quan den viee tang t / suat de non.
T O M TAT
Muc tieu: xac dinh diem cat eua nong dp ptiCG trong tien luttng so lirpng tiiai tren san phu dupc thu tlnti trong dng nghiem. Doi tUtfng: 1078 benh niian dupc tiiu tinh trong ong nghiem co xet ngiiiem phCG ngay 14 sau ciiuyen phoi > 5mIU/mL va ket qua sieu am d^u do am dao 28 ngay sau chuyen phoi khi cd it nhat 1 till ol trong buong tir cung. Phu'dng phap:
theo phu'dng phap hoi cuti md ta. Ket qua: Nong do PhCG trung binh d nhom chira 3 thai la 1211,21 ± 779,69 mlU/mL, nhom ehua 2 thai la 934,01 ± 663,99 mlU/mL, nhom chu^ 1 thai la 581,86 ± 670,22 mlU/mL sir khac biet co y nghta thong ke P < 0,001.
Oiem cut-off cua nong do ph03 tien luUng diiia da thai la 600,5 mlU/mL vdl do nhay 71,4%, do d3c hieu 69,1%, AUC = 0,759. KSt luan: Diem cut-off cua noiig dp phCG CO gia tri bong viec tien lUdng chifa da thai.
T&kh6a:\!n\i tinh trcing ong nghiem, PhCG, da thai.
SUMIVIARY
PREDICTIVE VALUE OF B-HCG ON THE DAY 14 AFTER EMBRYO TRANSFERATION TO
NUMBER OF FETUS I N IVF
*TTho trd sinh san Qude Gia,Benh viin Phu san TW Chju trach nhiem chinh: Nguyin Xuan Hpi Email; [email protected] Ngay nhan bai: 12.01.2017 Ngay phan bien khoa hoc: 17.3.2017 Ngay duyet bai; 3.4.2017
256
TAP CHi Y HOC VIET NAM TAP 454 - THAHG 5 . SO 1 • 2017 hi* vong chu sinh va cae bien chiTng thai ky... Vi
vay, nhieu bien phap da dddc thi/e hien de giam ty le chii^ da thai, mpt trong cae bien phap do la giam thieu thai. Tuy nhien, viee giam thieu d tudi thai cang Idn thi eang khd, nguy ed cho me va thai cang tang. Thong thu'dng, ky thuat nay du'pc thyc hien khi thai du'dc 7 - 8 tuan du'di su' hirdng dan ciia sieu am, tuy nhien cd nhieu tru'dng hpp den vien khi tuan thai ldn, khdng the giam thieu du'dc vi cd the gap nhieu bien chirng cho me va thai. Nhu' vay, neu ed the ehan doan sdm chira da thai tir do tu' van benh nhan nhap vien dung thdi diem de giam thieu la viec vo ciing quan trpng. I«l6t trong nhij'ng xet nghiem giup chan doan sdm la djfrh lu'dng nong dp phCG vao ngay thir 14 sau ehuyen phoi. Phu nQ' chu^
da thai, nong dd phCG thu'dng cao hdn phu nd chira ddn thai. Nham xae dmh mdi lien quan giUa nong dp phCG vdl so lu'dng thai lam to trong buong tir cung, gdp phan ehan doan sdm chda da thai va tu' van cho ngu'di benh, ehiing toi b'en hanh nghien cii'u "Gia tri tiin idghg cua nong do (ShCG 14 ngay sau ehuyi'n phoi ddi vdi so Idcfng thai sau thu tinh trong dng nghiem"
vdl muc tieu: Xac djnh die'm cut-off cua nong do PhCG M ngay sau ehuyi'n phoi ddi vdi sd lu'dng thai sau thu tinh trong ong nghiem.
II. DOI Tl/ONG VA PHU'ONG PHAP NGHIEN CUTJ 2.1. Boi t&dng: Bao gom 1078 benh nhan du'dc thu tinh trong ong nghiem nam 2014 - 2015 tai Trung tam ho trd sinh san Quoc gia - benh vien Phu san Trung irdng, phii hdp vdi tieu chuan lira chon va tieu chuan loai trir deu du'dc du'a vao nghien cii'u.
III. KET QUA NGHIEN CO'U
3.1 Dac diem chung cua doi tu'dng nghi§n cu'u Bang 1. Tuoi cua ddl t&dng nghien c&u
2.2. Tiiu diuan l&a digm Benh nhan dddc thu tmh trong ong nghiem tai Trung tam ho trd sinh san Quoe gia - benh vien Phu san Trung u'dng tiy 2104 - 2015, cd xet nghiem phCG ngay 14 sau chuyen phdi > 5mIU/mL, ket qua sieu am sau 4 tuan chuyen phoi cd it nhat 1 tui oi trong buong tu" eung, ed day dii thdng tin va yeu t d nghien eiru.
2.3. Tiiu chuan loai ti-&:lhai s\nh hda; sau ehuyen phoi cd tiem hCG; benh nhan du'dc thu tinh trong ong nghiem tai cd sd khae, khong dii thong tin nghien ciru.
2.4. Tiiu chuan nghiin ciiir. Cd thai: xet nghiem phCG 14 ngay sau chuyen phdi > 5 mlU/mL; Sieu am dau dd am dao danh gia so lu'dng th^ai vao thdi diem 4 tuan sau chuyen phoi (thdi diem nay tu'dng du'dng thai du'dc 6 tuan tuoi). Da thai la ed > 2 till thai du'dc'quan sat thay tren sieu am.
2.5. Thiii ke nghiin c&u: Hoi ciilj mo ta 2.6. Cd mau nghien c&u: C3 mau thuan tien, tat ea benh nhan thda man tieu ehuan lu'a ehpn va tieu chuan loai trir deu du'dc du'a vao nghien ciTu.
2.7. X&ly so lieu: So lieu thu thap du'dc xu"
ly tren phan mem SPSS 20.0 vdi cae test: T-test, sir dung du'dng cong ROC (Receiver Operating Characteristic Curve) tim diem eut-olT eua nong dp phCG trong tien lu'dng so thai sau thu tinh dng nghiem... Dimg ehi so Youden (Youden index) J de xae djnh nong dp phCG nao cd dp nhay va dp dac hieu cao nhat. Chl so J la tn so cao nhat eiia tong dp nhay va dp dac hieu trir di 1. J = max (Se+Sp -1) vdi Se (Sensitivity) la dp nhay va Sp (specificity) la dp dac hieu.
Tuoi Tan so Ty le % Tuoi trung binh ^ ± SD
<25 45 4,2
41,6 35,8
15,1 31,4 ± 4,6
Tong
3,3
Nh$n xet: Tuoi trurig bmh ciia nhom nghien eiru; 31,4 ± 4,6 benh nhan t i p trung chii yeu d nhdm tuoi tiT 25 - 30 tuoi, tuoi nhd nhat la 20 va Idn nhat la 52.
Bang 2. Nguyen nhin gay vd sinh dddi tWdng nghiin c&u Nguyen nhan vo sinh
Do voi tiy cunq Roi loan phonq noan Tinh triinq bat thu'dnq Khonq ro nquyen nhan TLT cunq bat thUcJnq
Tan so 414
14 222 334 49
Tv le % 38,4
1,3 20,6 31,0 4,5
Do ca 2 vdchonci Nquyen nhan ktiac Lac noi niac tu* cunq
Tong 1 0 0 %
Nhan xet: Nguyen nhan gay vo sinh d doi tUdng nghien cu'u chu yeu do voi \il cung (38, I<h6ng ro nguyen nhan chiem 31,0%; cac nguyen nhan do iac ngi mac tCr cung, roi loan phong noan va tu' cung bat thu'dng chiem ty le rat thap.
Bang 3: Sdphdi chuyen vao budng tu" cung T a n s
So phoi chuyen Ty le °/o So phoi chuyen trung binh x ± sD
1 2,2
6,3 72,4 Tong
Nhan xet; So pho chuyen trung bmh la 3,08 ± 0,58. Chuyen it nhat 1 phoi, nhieu nhat la 4 phoi.
Trong do hay gap nhat la chuyen 3 phoi (72,4%).
Bang 4; lien quan giu'a sdphdi chuyen vao budng td cung va ty ie chda da thai Tong
Tong
Tyle'!
Ty le % 4,1%
Ty le %
111 Ty le % 18,2%
Ty le % 609
20,0°/i 100°,<
469 100%
1078
100%
J
Nhan xet: Ty le chCte da thai ty le thuan vdi so phoi chuyen vao buong tir cung. Ty le chu'a da thai d nhom chuyen 3 phoi (75,9%) cao hdn nhieu ^ n so vdi nhdm chuyen 2 phoi (4,1%), si/ khac biet CO y nghTa thong ke vdl p < 0,001.
3.2 Gia tri nong do phCG trong viec tien lu'dng so tui thai
Bang 5; Uen quan giu'a sdlUdng tui thai va nong dd 0hCG trung binh Tan so Ty le o/o Nong do phCG trung binh x ± SD
56,5 581,86 ± 670,22
934,01 ± 663,99
Tong „
0,6
1211,21 ± 779,69 1 0 0 %
1069,27 ± 646,01
0,001
Nhan xet: Nong do phCG trung binh d nhom chu^ 1 thai la 581,86 ± 670,22mItJ/mL, d nhdm chlla 2 thai la 934,01 ± 663,99mIU/mL, d nhom chu'a 3 thai la 1211,21 ± 779,69, va nhdm chiis 4 thai la 1069,27 ± 646,01mIU/mL Nong dp phCG trung binh d nhdm chira da thai cao hdn nhom chu'a ddn thai cd y nghTa thong ke vdi p < 0,001.
^Banq 6: Gia trj tien lu'dng cua PhCG doi vdi tinh trang thai ' — ^ ^ _ 6 i a tri c h a n d o a n
PhCG ( m l U / m L ) ^-^ ^ _ _ 592,0
594,5 597,0 598,5 599,5 600,5 601,5 602,5 603,5
D o n h a y % 72,7 72,7 72,5 72,5 72,5 71,4 71,0 70,8 70,6
D o d a c h i e u % 66,3 66,5 66,5 67,0 67,3 69,1 69,1 69,1 69,1
Gia trj J 0,39 0,392 0,390 0,395 0,398 0,405 0,401 0,399 0,397
Nhin xet: Diem cut-oiT eua phCG tien lu'dng cho chiTa da thai la 600,5 mlU/mL, vdi do nhay 71,4%, dp dac hieu 6 9 , 1 % , va gia trj J Idn nhal: 0,405.
ty le da thai cao nhat ehiem 75,9% (356/469), nhdm chuyen 2 phdi ty le nay la 4 , 1 % (19/469), va d nhdm ehuyen 4 phoi la 20% (94/469), ty le chira da thai d nhdm chuyen 3 phoi eao gap 18 lan so vdi nhom chuyen 2 phoi, sir khac biet cd y nghta thdng ke vdi p < 0,001. Tuy nhien, siT phan bd ve tan so so lu'dng phoi ehuyen giij'a cae nhdm la khong dong deu, cu the nhdm ehuyen 2 phoi 6,3% (68/1078), nhdm chuyen 3 phdi 72,4% (781/1078), nhdm ehuyen 4 phoi 19%
(205/1078), Chuyen 1 phoi 2,2% (24/11078).
Chuyen bao nhieu phoi trong 1 ehu ky de lam giam ty le chira da thai nhu^g van giU du'dc ty le ed thai lam sang cao la van d ^ chu'a diTdc thong nhat giu'a eac trung tam ho trd sinh san, bdi no phu thude vao nhieu yeu to nhu" ddi tu'dng dieu trj, so phdi thu du'dc, kinh nghiem ngu'di ehuyen, tdn giao, quy djnh phap luat..Theo Nguyen Xuan Huy (2004) nghien cull 519 tru'dng hdp thu tinh ong nghiem thay: ty le thai lam sang bang 10%
d nhdm ehuyen 1 phoi, 19,2% khi ehuyen 2 phoi va 37,8% neu chuyen 3 phdi [2]. Hassan N Sallam (2004) nhan thay ty le thanh eong trong 1 chu ky dieu tn ty le thuan vdi so phoi chuyen, t / le cd thai la 13% d nlidm chuyen < 3 phdi, 23% d nhdm ehuyen 4 phoi va 27% d nhdm chuyen 5 phdi [7]. Tuy nhien, ehuyen nhieu phdi trong 1 chu ky dieu tn cung lam t^ng ty le chii^
da thai. Mac dii vay, vdi nhu'ng tien bp ve ho trd sinh san hien nay, cimg vdi sir phat trien trong nuoi cay phdi cho phep giam sd lu'dng phdl chuyen_ trong moi chu ky ma ty le ed thai lam sang v l n du'dc dam bao.
Lien quan giu'a so lu'dng tui thai va nong do phCG trung binh: Ket qua nghien cu'u cita Chung tdi cho thay, nong dd phCG trung binh d nhdm chira 3 thai eao nhat (1211,21 ± 779,69 mlU/mL), nhdm ehu^ 2 thai va nhdm chii^ 1 thai thap hdn, lan lu'dt la 934,01 ± 663,99 mlU/mL va 581,86 ±. 670,22 mlU/mL Nong do phCG trung binh giCTa cac nhdm chiTa 1 thai, 2 thai va 3 thai cd sy" khac biet cd y nghla thong ke vdi p
<0,001. Theo nghien ciru ciia P. Poikkeus (2002) nong dp phCG trung binh ngay thu" 12 sau chuyen phoi d nhdm chira 1 thai (115mIU/mL), gan gap ddi nhdm chu^ da thai (201mIU/mL) vdi p<0,001 [3]. Nghien ciru ciia Krithika Devi Jayaehandran va cpng sir (2010) eho ket qua:
neu ehuyen phoi ngay 2, nong dd phCG trung binh 14 ngay sau chuyen phdi d nhdm chira ddn Bleu do 1: Dien tieh du'dng cong ROC
trong tien lu'dng da thai Nhan xet: Dien tich du'di du'dng eong ROC (AIJC = 0,759) ^ d gia trj trong vlee ehan doan chifa da thai, moi lien quan nay cd y nghTa thong ke vdi p < 0,001, a (0,73 - 0,79).
IV. BAN L U A N
Dac di€m cua doi tu'dng nghien cihi: Tuoi trung binh cua doi tu'dng nghien ciru: 31,4 ± 4,6 tuoi, benh nhan tap trung chii yeu d nhdm tuoi tuf 25 - 30 tuoi ( 4 i , 6 % ) , tudi nhd nhat la 20, Idn nhat la 52. Day cung la nhdm dang trong dp tuoi sinh de, dong thdi la dp tuoi co nhu cau va nguyen vpng sinh con cao nhat. Op tuoi cd kha nhieu anti hu'dng den ket qua cd thai d ddi tu'dng thu tinh trong ong nghiem, do cd lien quan den diT triJ buong tru'ng, ngu'di ta nhan thay tuoi cang eao thi dir t r d buong trimg cang giam, dac biet sau tuoi 35. Theo nhieu nghien ciru eiia eac tae gia trong va ngoai nu'dc, tudi cang eao thi eang bat ldi cho sy" thu thai va sir phat trien ciia thai, dong thdi anh hu'dng khdng
^ t vdi ehi'nh sii'c khde ciia ngu'di me, dae biet la eac thai ky da thai. Ket qua nghien eiTu eiia ehung toi thay, nguyen nhan gay vo sinh chu yeu do vol tu' eung chiem 36,6%, day cung la nguyen nhan vo sinh ed tien lu'dng tot nhat trong thu tinh ong nghiem. Nghien eiru eiia Vu'dng Thj Ngoe l^n (2003) ty le vo sinh do vdi tir eung la 84% [1]; Nguyen Xuan Huy (2004) la 81,9% [2].
Ty le vo sinh do vdi tu" cung trong nhii'ng nam gan day ed xu hu'dng thap hdn so vdi tru'dc la do hieu qua eiia giao due ve sinh sinh san lam giam benh ly lay truyen qua du'dng ttnh due, tinh trang nao hut tliai, va ky thuat md' npi soi gd dinh vdi ngay eang du'dc hoan thien lam giam cae ehi djnh thu tinh dng nghiem do nguyen nhan tac vdi tu'cung.
Uen quan giu'a so phoi chuyen vao buong tur cung va ty le chfiTa da thai: Nghien CIJ'U eiia chiing tdi eho thay nhdm ehuyen 3 phoi.
thai la 381mIU/mL, nhdm chu'a song thai la 503 mlU/mL; neu chuyen phoi ngay 3, nong dp phCG trung binh 14 ngay sau chuyen phoi d nhdm ehu^ ddn thai la 503mIU/mL, d nhom chu'a song thai la 1503mIU/mL [43.
Nhu" vay, nong dp phCG trung binh eiia eac nhdm ddi tu'dng nghien cdu eua moi tac gia la khdng hoan toan giong nhau, nd phu thupc vao nhieu yeu to nhu' ngay ehuyen phdi, thcfl diem djnh lu'dng phCG... Tuy nhien, ed the thay rang nong dd phCG trung binh d nhdm chii^ nhieu thai cao hdn d nhdm ehiici it thai, hay ndi each khac nong dp phCG trung binh ty le thuan vdi so lu'dng till thai ma san phu mang.
Gia trj t i e n lu'dng cua nong do phCG ngay thuf 14 sau c h u y e n phoi doi chu'a da t h a i : Nghien ciru cua chiing toi tim ra diem cut- off tien lu'dng chda da thai la 600,5mHJ/mL, do nhay 71,4%, do dac hieu 69,1%, AUC = 0,759, vdi p < 0,001. Nghien eiru cua Guth B va cpng sir (1995) theo doi 111 chu k/ IVF ed du'dng ti'nh vdi phCG sau chuyen phoi 14 ngay cho ket qua;
Neu phCG < 300 mlU/mL t / le da thai tien trien la 9% (5/57), neu phCG tiT 300 - 600mIU/mL ty le da thai 40% (10/25), neu phCG> 600mIU/mL ti- le da thai 100% (7/7) [5]. Xiao-yan HUANG (2007) nghien cirU 384 tru'dng hdp IVF, du'dc djnh lu'dng phCG vao ngay thir l i sau ehuyen phoi thay rang nong dp pCG d nhdm chiici da thai cao hdn nhom chira ddn thai; neu phCG >
250mIU/mL, gia tn tien doan du'dng tinh chiTa da thai la 83,3%, gia tri tien doan am tinh la 74,4%[6]. Nhu" vay nghien cud eiia ehung toi chi ra rang, gia trj 66o,5mIU/mL la diem cut-off gdi y chuan doan chu^ da thai, ed nghTa rang neu thai phu cd nong dp phCG huyet thanh >
600,5mIU/mL thi co nhieu kha nang chu'a da thai, neu nong dp phCG < 600,5mIU/mL thi tien lu'dng chira ddn ^ a i .
V. KET LUAN
- Nong dp :PhCG trung binh d nhdm chift 3 thai cao hdn nhom chu'a 2 thai va cao hdn nhom chu^ Ithai.
- Ty le chiici da thai tang len theo so lu'dng phoi ehuyen vao buong tii eung
- Diem cut-off nong dp phCG tien lu'dng eho ehufa da thai la 600,5mIU/mL, vdi do nhay 71,4%, dp dae hieu 6 9 , 1 % , AUC = 0,759^ Gia trj nay rat cd y nghTa trong viec tien lu'dng tinli trang thai va tu' van eho ngu'di benh.
TAI LIEUTHAM KHAO
1. Vu'dng Thj Ngpc L^n, Ho Manh Tu'cfng (2003),
"Mot so cai ben nham nang cao ty le thanh c6ng ciia chiUOng trinii tiiu tinh trong dng nghiem", Vo sinh -J4gtsovan demdl, Nha xuat ban Y hoc.
z. Nguyen Xuan Huy (2004), Nghiin cdu ketqua &7ii dnh trong dng nghiem tai benh viin Phu san Trurig IfOig nam 2003, Luan van tdt nghiep bac sy diuyen khoa cap II, TnTdng Oai hpc Y Ha N6i, 3 - 52.
3. Poikkeus P, Hiilesmaa V, Tiitinen A(2002), Serum HCG 12 days al^er embryo transferin predicting pregnancy outcome, Wi//77 Repmd;
17(7):1901-5.
4. Krithika Devi Jayaehandran, Pandiyan Natarajan, Radha Pandiyan (2010), First postembryo transfer beta-hCG level and pregnancy outcome in an assisted reproductive technology program. International Journal of Infertility and Fetal Medicine, Vol. 3, No. 2.
5. Guth B, Hudelson J, Higbie J, Solomon B, Pollev S, Thomas S, Gentry WL {199S}.Predid:ive value ofhCG level 14 days alter embryo transfer. J Assist ReprodGenet; 12(1): 13-4.
6. Xiao-yan HUANG, Yuna ZANG, Hai-qin YU (2007). Serum beta hCG of 11 day after embryo transfer to predict pregnancy outcome. Joumal of Reproduction and Contracepdon 18(3): 213-219.
' Hassan N Sallam (2004), "Embryo transfer - a critique of the factor invovel in optimizing pregnancy success". Advance in fertility and reproduaive medicine, IFFS, 111-117.
DANH GIA KET QUA SaM DIEU TRI DIEC DOT NGOT TAI KHOA TAI MUI HONG - BENH VIEN TRUNG UffNG T H A I NGUYEN
Nguyen Cong Hoang*, Nguyen Thi Ngoc Anh*
T 6 M TAT
Mijc tieu: Danh gia ket qua s ^ dieu trj diec dot ngpt tai khoa Tai mui hpng - Benh vien Trung U'Ong
^Trddng Dai hgc Y Dddc Thai Nguyin Chju trach nhiem ciiinh: Nguyen Cdng Hoang Email: [email protected] Ngay nhan bai: 20.01.2017 Ngay phan bien khoa hpc: 29.3.2017 Ngay duyet bai: 11.4.2017
Thai Nguyen. Phu'dng phap: Nghien ciru tien cifu mo ta tirng tru'dng lipp._ Ket qua: Tuoi trung binh 49,3;
nhom tuoi >55 tuoi ciiiem 57,7%. Ti le gidi: nam (40,4%), nff (59,6%). Mot so yeu to nguy cd: tSng huyet ap (17,3%), cam ciim (9,6%), dai tiiao du'dng (5,8%), quai bi (3,8%). Trieu chufng cO nang: nqhe kem (100%), ii tai (86,5%), chong mat (48,1%). Hmh thai thinh IUc do: loai B (50,9%), loai C (21,8%), loai D (10,9%), loai A (9,1%), loai E (7,3%). Ty le cai thien trieu chiiiig cd nang: nghe kem (80%), u tai (68,3%), chong mat (100%). Ty le hoi phuc thinh lut
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